The study aim was to analyze patterns of health services utilization after diagnosis among veterans with colorectal cancer and differentiate patients with a sole source of care (Department of Veterans Affairs (VA) or Medicare-reimbursed) from those with dual sources of care. Continuity of care may be lacking for dual users and real health care dollars are lost when patients cross over to another health system. All VA patients diagnosed with colorectal cancer and surgically treated for cure during the 5-year period 1989-1993, who were Medicare-eligible at diagnosis, and survived the index admission were included. Thirteen years of nationwide Medicare and VA inpatient and institutional outpatient data were analyzed beginning with the three years prior to diagnosis (1986-1990) through a minimum of five years after diagnosis (1994-1998). Of all veterans surgically treated for their initial colorectal tumor at the VA, 91 percent obtained all of their colorectal cancer inpatient care from the VA. Similarly, of those veterans who utilized institutional outpatient care and were surgically treated for their initial colorectal tumor at the VA, approximately 81 percent obtained all of their institutional outpatient care from the VA. Inpatient dual users (those who use both VA and Medicare-reimbursed systems of inpatient care) constituted slightly less than 10 percent of veterans diagnosed with and surgically treated for colorectal cancer. Similarly, institutional outpatient dual users constituted less than 15 percent of this population. Chronology of utilization and types of services utilized when patients switch from one source of care to another are currently under analysis.
Learning Objectives: At the conclusion of this session, the participant will be able to: 1. Identify the magnitude of Department of Veterans Affairs/Medicare-reimbursed dual use of health services among patients who were originally diagnosed with and surgically treated for their initial colorectal cancer at the VA. 2. Describe the implications of using health services from multiple health care systems. 3. List the types of health services utilized when patients switch from one source of care to another.
Keywords: Health Care Utilization, Health Care Access
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.