ArticleJournal of the American Geriatrics Society2017
Innovation in a Learning Health Care System: Veteran-Directed Home- and Community-Based Services.
Article in Journal of the American Geriatrics Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03145818 (Evaluation of Veteran Directed Home and Community Based Services), which is not on this map. Cited by 13 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of Veteran Directed Home and Community Based Services
Who cites it
13 citing papers in PubMed, 24 citations in OpenAlex.
- Empowering Older Veterans Through Self-Directed Care: A Mixed Methods Evaluation of a Technology Enabled Respite Homecare Model Pilot.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Improving information sharing in Medicaid home and community-based services with learning health systems: Implications for older adults and individuals living with disabilities and dementia.Learning health systems · 2025Article
- Use of Paid Family Care in the Community: National Trends Among Older Adults With Functional Impairment, 2011-2022.Journal of the American Medical Directors Association · 2025Article
- The Alliance for Healthier Communities' journey to a learning health system in primary care.Learning health systems · 2023Article
- Determinants of inter-organizational implementation success: A mixed-methods evaluation of Veteran Directed Care.Healthcare (Amsterdam, Netherlands) · 2022Article
- Fewer potentially avoidable health care events in rural veterans with self-directed care versus other personal care services.Journal of the American Geriatrics Society · 2022Observational
- The Indiana Learning Health System Initiative: Early experience developing a collaborative, regional learning health system.Learning health systems · 2021Article
- Learning health systems in primary care: a systematic scoping review.BMC family practice · 2021Article
- Leveraging natural experiments to evaluate interventions in learning health systems.BMJ quality & safety · 2021Article
- The Changing Dynamics of Providing Health Care to Older Veterans in the 21The Public policy and aging report · 2020Article
- Users Of Veteran-Directed Care And Other Purchased Care Have Similar Hospital Use And Costs Over Time.Health affairs (Project Hope) · 2019Article
- Overcoming Challenges to Evidence-Based Policy Development in a Large, Integrated Delivery System.Health services research · 2018Article
- VA Staff Perceptions of Barriers and Facilitators to Home-and Community-Based Placement Post-Hospital Discharge.Journal of aging & social policyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 6 institutions in 1 country.
Funding
Abstract
A path-breaking example of the interplay between geriatrics and learning healthcare systems is the Veterans Health Administration's (VHA's) planned roll-out of a program for providing participant-directed home- and community-based services to veterans with cognitive and functional limitations. We describe the design of a large-scale, stepped-wedge, cluster-randomized trial of the Veteran-Directed Home- and Community-Based Services (VD-HCBS) program. From March 2017 through December 2019, up to 77 Veterans Affairs Medical Centers will be randomized to times to begin offering VD-HCBS to veterans at risk of nursing home placement. Services will be provided to community-dwelling participants with support from Aging and Disability Network Agencies. The VHA Partnered Evidence-based Policy Resource Center (PEPReC) is coordinating the evaluation, which includes collaboration from operational stakeholders from the VHA and Administration for Community Living and interdisciplinary researchers from the Center of Innovation in Long-Term Services and Supports and the Center for Health Services Research in Primary Care. For older veterans with functional limitations who are eligible for VD-HCBS, we will evaluate health outcomes (hospitalizations, emergency department visits, nursing home admissions, days at home) and healthcare costs associated with VD-HCBS availability. Learning healthcare systems facilitate diffusion of innovation while enabling rigorous evaluation of effects on patient outcomes. The VHA's randomized rollout of VD-HCBS to veterans at risk of nursing home placement is an example of how to achieve these goals simultaneously. PEPReC's experience designing an evaluation with researchers and operations stakeholders may serve as a framework for others seeking to develop rapid, rigorous, large-scale evaluations of delivery system innovations targeted to older adults.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.