Kali S Thomas1,2, Emily Corneau1, Courtney H Van Houtven3,4, Portia Cornell1,2, David Aron5,6, David M Dosa1,2, Susan M Allen2. 1. Providence VA Medical Center, Providence, Rhode Island, USA. 2. School of Public Health, Brown University, Providence, Rhode Island, USA. 3. Durham VA Medical Center, Durham, North Carolina, USA. 4. Duke University School of Medicine, Durham, North Carolina, USA. 5. Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA. 6. School of Medicine, Case Western Reserve, Cleveland, Ohio, USA.
Abstract
OBJECTIVE: To examine characteristics that are associated with receipt of Aid and Attendance (A&A), an enhanced pension benefit for Veterans who qualify on the basis of needing daily assistance, among Veterans who receive pensions. DATA SOURCES: Secondary data analysis of 2016-2017 national VA administrative data linked with Medicare claims. STUDY DESIGN: Observational study examining sociodemographic, medical, and healthcare utilization characteristics associated with receipt of A&A among Veterans receiving pension. PRINCIPAL FINDINGS: In 2017, 9.7% of Veterans with pension newly received the A&A benefit. The probability of receiving A&A among black and Hispanic pensioners was 4.6 percentage points lower than for white pensioners (95%CI = -0.051, -0.042). Married Veterans receiving pension had a 4.4-percentage point higher probability of receiving A&A (95%CI = 0.039, 0.048). Most indicators of need for assistance (eg, home health utilization, dementia, stroke) were associated with significantly higher probabilities of receiving A&A, with notable exceptions: pensioners with a diagnosis of Post-Traumatic Stress Disorder (marginal effect = -0.029 95%CI = -0.037, -0.021) or enrolled in Medicaid (marginal effect = -0.053, 95%CI = -0.057, -0.050) had lower probabilities of receiving A&A. Unadjusted and adjusted rates of receiving A&A among Veterans receiving pension varied by VA medical center. CONCLUSIONS: This study identified potential inequities in receipt of the A&A enhanced pension among a sample of Veterans receiving pension. Increased Veteran outreach, provider education, and VA office coordination can potentially reduce inequities in access to this benefit.
OBJECTIVE: To examine characteristics that are associated with receipt of Aid and Attendance (A&A), an enhanced pension benefit for Veterans who qualify on the basis of needing daily assistance, among Veterans who receive pensions. DATA SOURCES: Secondary data analysis of 2016-2017 national VA administrative data linked with Medicare claims. STUDY DESIGN: Observational study examining sociodemographic, medical, and healthcare utilization characteristics associated with receipt of A&A among Veterans receiving pension. PRINCIPAL FINDINGS: In 2017, 9.7% of Veterans with pension newly received the A&A benefit. The probability of receiving A&A among black and Hispanic pensioners was 4.6 percentage points lower than for white pensioners (95%CI = -0.051, -0.042). Married Veterans receiving pension had a 4.4-percentage point higher probability of receiving A&A (95%CI = 0.039, 0.048). Most indicators of need for assistance (eg, home health utilization, dementia, stroke) were associated with significantly higher probabilities of receiving A&A, with notable exceptions: pensioners with a diagnosis of Post-Traumatic Stress Disorder (marginal effect = -0.029 95%CI = -0.037, -0.021) or enrolled in Medicaid (marginal effect = -0.053, 95%CI = -0.057, -0.050) had lower probabilities of receiving A&A. Unadjusted and adjusted rates of receiving A&A among Veterans receiving pension varied by VA medical center. CONCLUSIONS: This study identified potential inequities in receipt of the A&A enhanced pension among a sample of Veterans receiving pension. Increased Veteran outreach, provider education, and VA office coordination can potentially reduce inequities in access to this benefit.
Authors: Donald Musa; Richard Schulz; Roderick Harris; Myrna Silverman; Stephen B Thomas Journal: Am J Public Health Date: 2008-10-15 Impact factor: 9.308
Authors: Thomas Edes; Bruce Kinosian; Nancy H Vuckovic; Linda Olivia Nichols; Margaret Mary Becker; Monir Hossain Journal: J Am Geriatr Soc Date: 2014-10 Impact factor: 5.562
Authors: Kali S Thomas; Emily Corneau; Courtney H Van Houtven; Portia Cornell; David Aron; David M Dosa; Susan M Allen Journal: Health Serv Res Date: 2021-02-25 Impact factor: 3.734
Authors: Kali S Thomas; Emily Corneau; Courtney H Van Houtven; Portia Cornell; David Aron; David M Dosa; Susan M Allen Journal: Health Serv Res Date: 2021-02-25 Impact factor: 3.734