ArticleHealth services research2018
External Determinants of Veterans' Utilization of VA Health Care.
Article in Health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed.
- Camaraderie Among US Veterans and Their Preferences for Health Care Systems and Practitioners.JAMA network open · 2025Article
- Social support networks and well-being of disabled veterans: the dual roles of institutional support and peer trust.Frontiers in psychology · 2025Article
- Article
- Early Impact of VA MISSION Act Implementation on Primary Care Appointment Wait Time.Journal of general internal medicine · 2023Article
- Effect of the Affordable Care Act on healthcare utilization for Veterans with spinal cord injuries and disorders.The journal of spinal cord medicine · 2022Article
- Design and implementation of a cluster randomized trial measuring benefits of medical scribes in the VA.Contemporary clinical trials · 2021Article
- Assessment of Extractability and Accuracy of Electronic Health Record Data for Joint Implant Registries.JAMA network open · 2021Article
- Ethnic Disparities in Imaging Utilization at Diagnosis of Non-Small Cell Lung Cancer.Journal of the National Cancer Institute · 2020Article
- Regional market factors and patient experience in primary care.The American journal of managed care · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveVeterans' utilization of Veterans Affairs (VA) health care is likely influenced by community factors external to the VA, including Medicaid eligibility and unemployment, although such factors are rarely considered in models predicting such utilization. We measured the sensitivity of VA utilization to changes in such community factors (hereafter, "external determinants"), including the 2014 Medicaid expansion following the Affordable Care Act. DATA SOURCES/STUDY
settingWe merged VA health care enrollment and utilization data with area-level data on Medicaid policy, unemployment, employer-sponsored insurance, housing prices, and non-VA physician availability (2008-2014). STUDY
designFor veterans aged 18-64 and ≥65, we estimated the sensitivity of annual individual VA health care utilization, measured by the cost ($) of care received, to changes in external determinants using longitudinal regression models controlling for individual fixed effects. PRINCIPAL
findingsAll external determinants were associated with small but significant changes in VA health care utilization. In states that expanded Medicaid in 2014, this expansion was associated with 9.1 percent ($826 million) reduction in VA utilization among those aged 18-64; sizable changes occurred in all services used (inpatient, outpatient, and prescription drugs).
conclusionsChanges in alternative insurance coverage and other external determinants may affect VA health care spending. Policy makers should consider these factors in allocating VA resources to meet local demand.
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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.