title: Prevalence and costs of chronic conditions in the VA health care system.
abstract: Chronic conditions are among the most common causes of death and disability in the United States. Patients with such conditions receive disproportionate amounts of health care services and therefore cost more per capita than the average patient. This study assesses the prevalence among the Department of Veterans Affairs (VA) health care users and VA expenditures (costs) of 29 common chronic conditions. The authors used regression to identify the marginal impact of these conditions on total, inpatient, outpatient, and pharmacy costs. Excluding costs of contracted medical services at non-VA facilities, total VA health care expenditures in fiscal year 1999 (FY1999) were $14.3 billion. Among the 3.4 million VA patients in FY1999, 72 percent had 1 or more of the 29 chronic conditions, and these patients accounted for 96 percent of the total costs ($13.7 billion). In addition, 35 percent (1.2 million) of VA health care users had 3 or more of the 29 chronic conditions. These individuals accounted for 73 percent of the total cost. Overall, VA health care users have more chronic diseases than the general population.
authors.affiliation: VA HSR&D Health Economics Resource Center, Center for Health Policy, Center for Primary Care and Outcomes Research, Stanford University, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Yu
authors.forename: Arliene
authors.initials: A
authors.lastname: Ravelo
authors.forename: Todd H
authors.initials: TH
authors.lastname: Wagner
authors.forename: Ciaran S
authors.initials: CS
authors.lastname: Phibbs
authors.forename: Aman
authors.initials: A
authors.lastname: Bhandari
authors.forename: Shuo
authors.initials: S
authors.lastname: Chen
authors.forename: Paul G
authors.initials: PG
authors.lastname: Barnett
mesh_terms: D000367:Age Factors; D000553:Ambulatory Care / Q000191:economics; D002423:Cause of Death; D002908:Chronic Disease / Q000191:economics / Q000453:epidemiology; D015897:Comorbidity; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006302:Health Services Research; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D017059:Models, Econometric; D010593:Pharmaceutical Services / Q000191:economics; D011159:Population Surveillance; D015995:Prevalence; D012044:Regression Analysis; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000191:economics / Q000706:statistics & numerical data