Evaluation of veteran-directed home and community based services on older veterans’ health care use and costs

Not Applicable

Completed

• Conditions: Functional (needs assistance with 3 or more Activities of Daily Living) and/or cognitive limitations that place individuals at risk of nursing home placement; Mental and Behavioural Disorders

• Registration Number: ISRCTN12228144
• Lead Sponsor: Department of Veterans Affairs Health Services Research & Development

Brief Summary

2019 Results article in https://pubmed.ncbi.nlm.nih.gov/31158026/ results (added 24/05/2020) 2017 Protocol article in https://pubmed.ncbi.nlm.nih.gov/28832927/ (added 25/08/2022) 2022 Results article in https://pubmed.ncbi.nlm.nih.gov/35026056/ (added 25/08/2022)

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2017-03-21
• Study Completion: 2020-09-01
• Last Update Posted: 5 September 2022

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 37407

Inclusion Criteria

VAMC inclusion criteria (cluster level):
Site does not yet have an operational VD-HCBS program

VHA enrollee criteria (individual level)*:
1. Aged 75 and older
2. Jen Frailty Index (VA-data only) of 6 or higher
3. Had at least one inpatient or outpatient visit in the VHA system in the past year”
*Exact enrollee criteria will differ by site, as sites are allowed flexibility in choosing who to refer to the program

Exclusion Criteria

VAMC criteria (cluster level)
1. Site has nearly completed readiness review and is unable to delay enrollment
2. Facility leadership not interested in implementing VD-HCBS program

VHA enrollee criteria (individual level)
There are no exclusion criteria for individual enrollment in VHA.

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<br> 1. Any hospitalization is measured using administrative data collected by the VA Corporate Data Warehouse at 60-day increments for six months<br> 2. Any emergency department visit is measured using administration data collected by the VA Corporate Data Warehouse at 60-day increments for six months<br> 3. Nursing home admissions (VA community living center and contracted nursing homes) is measured using administrative data collected by the VA Corporate Data Warehouse at 60-day increments for six months<br> 4. Total health care costs (VA, Medicare, Medicaid) are assessed using administration data collected by VA Corporate Data Warehouse data, Medicare data, and Medicaid data at 60-day increments for six months<br>