Health care expenditures for urban and rural veterans in Veterans Health Administration care.
OBJECTIVE
To compare Veterans Health Administration (VA) patients, non-VA-using veterans, and nonveterans, separated by urban/rural residence and age group, on their use of major categories of medical care and payment sources.


METHODS
Expenditures for health care-using men in Medical Expenditure Panel Surveys from 1996 through 2004.


METHODS
Retrospective, cross-sectional analysis.


METHODS
Controlling for demographics, health status, and insurance, we compared groups on population-weighted expenditures for inpatient, hospital-based outpatient, office-based, pharmacy, and other care, by major payers (self/family, private insurance, Medicare, other sources, and VA).


RESULTS
VA users received most of their health care outside of the VA system, paid through private insurance or Medicare; self-payments were substantial. VA users under 65 reported worse health if they were rural residents but also lower expenditures overall and less care through private insurance.


CONCLUSIONS
VA health care users get most of their medical care from non-VA providers. Working-age VA users have less insurance coverage and rely more on VA care if they live in rural areas.
West
Alan N
AN
Veterans Rural Health Resource Center - Eastern Region, White River Junction, VT, USA. alan.west@va.gov
Weeks
William B
WB
D000328:Adult; D000367:Age Factors; D000368:Aged; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D014493:United States Department of Veterans Affairs / Q000191:economics* / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*