Premium
Comprehensive support of family caregivers: Are there health system cost offsets?
Author(s) -
Van Houtven Courtney Harold,
Smith Valerie A.,
Stechuchak Karen M.,
Berkowitz Theodore S. Z.,
Miller Katherine E. M.,
ShepherdBanigan Megan,
Kabat Margaret,
Henius Jennifer
Publication year - 2020
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13312
Subject(s) - veterans affairs , medicine , confidence interval , health care , total cost , demography , cohort , treatment and control groups , cohort study , gerontology , sociology , economics , microeconomics , economic growth
Objectives To examine the effect of the Department of Veterans Affairs’ (VA) Program of Comprehensive Assistance for Caregivers (PCAFC) on total VA health care costs for Veterans. Data Sources VA claims. Study Design Using a pre‐post cohort design with nonequivalent control group, we estimated the effect of PCAFC on total VA costs up through 6 years. The treatment group included Veterans ( n = 32 394) whose caregivers enrolled in PCAFC. The control group included an inverse probability of treatment weighted sample of Veterans whose caregivers were denied PCAFC enrollment ( n = 38 402). Data Extraction May 2009‐September 2017. Principal Findings Total VA costs pre‐PCAFC application date were no different between groups. Veterans in PCAFC were estimated to have $13 227 in VA costs in the first 6 months post‐PCAFC application, compared to $10 806 for controls. Estimated VA costs for both groups decreased in the first 3 years with a narrowing, but persistent and significant, difference, through 5.5 years. No significant difference in VA health care costs existed at 6 years, approximately $10 000 each, though confidence intervals reflect significant uncertainty in cost differences at 6 years. Conclusions Increased costs arose from increased outpatient costs of participants. Sample composition changes may explain lack of significance in cost differences at 6 years because these costs comprise of early appliers to PCAFC. Examining 10‐year costs could elucidate whether there are long‐term cost offsets from increased engagement in outpatient care.