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Trends in Rates and Attributable Costs of Conditions among Female VA Patients, 2000 and 2008

  • Jean Yoon
    Correspondence
    Correspondence to: Jean Yoon, PhD, MHS, 795 Willow Rd (152 MPD), Menlo Park, CA 94025. Phone: 650-493-5000; fax: 650-617-2639.
    Affiliations
    Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, California

    Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, California
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  • Jennifer Y. Scott
    Affiliations
    Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, California
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  • Ciaran S. Phibbs
    Affiliations
    Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, California

    Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, California

    Health Research and Policy Department, Stanford University, Stanford, California

    Pediatrics Department, Stanford University, Stanford, California
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  • Susan M. Frayne
    Affiliations
    Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, California

    Division of General Internal Medicine, Stanford University, Stanford, California
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      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.