Abstract
Research Objective
We examined rates of specific health conditions among female veteran patients and
how the share of health care costs attributable to these conditions changed in the
Veterans Affairs system between 2000 and 2008.
Methods
Veterans’ Administration (VA)-provided and VA-sponsored inpatient, outpatient, and
pharmacy utilization and cost files were analyzed for women veterans receiving care
in 2000 and 2008. We estimated rates of 42 common health conditions and per-patient
condition costs from a regression model and calculated the total population costs
attributable to each condition and changes by year.
Results
The number of female VA patients increased from 156,305 in 2000 to 266,978 in 2008;
88% were under 65 years of age. The rate of women treated for specific conditions
increased substantially for many gender-specific and psychiatric conditions: For example,
pregnancy increased 133%, diagnosed posttraumatic stress disorder increased 106%,
and diagnosed depression increased 41%. Mean costs of care increased from $4,962 per
woman in 2000 to $6,570 per woman in 2008. Psychiatric conditions accounted for more
than one quarter of population health care costs in 2008. Gender-specific conditions
and musculoskeletal diseases accounted for a rising share of population costs and
rose to 8.2% and 8.7% of population costs in 2008, respectively.
Conclusion
Gender-specific, cancer, musculoskeletal, and mental health and substance use disorders
accounted for a greater share of overall costs during the study period and were primarily
driven by higher rates of diagnosed conditions and, for several conditions, higher
treatment costs.
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Biography
Jean Yoon is a Health Economist in the VA Palo Alto, Menlo Park, CA. Her research interests involve chronic disease care and incentives for patients and providers in the management of disease.
Biography
Jennifer Y. Scott was a Statistical Analyst in the VA Palo Alto, Menlo Park, CA during the writing of this paper. Her research interests involve statistical analysis of cost data.
Biography
Ciaran S. Phibbs is a Health Economist in the VA Palo Alto, Menlo Park, CA and in Stanford University, Stanford, CA. He conducts research on perinatal care, nurse staffing, and hospital markets.
Biography
Susan M. Frayne is an Investigator in the VA Palo Alto, Menlo Park, CA and in the Division of General Internal Medicine, Stanford University, Stanford, CA. Her research includes mental illness, PTSD, and violence against women.
Article info
Publication history
Accepted:
March 9,
2012
Received in revised form:
February 15,
2012
Received:
August 2,
2011
Identification
Copyright
Published by Elsevier Inc.
