Thomas KS, Corneau E, H Van Houtven C, Cornell P, Aron D, M Dosa D, M Allen S. Inequities in access to VA'S aid and attendance enhanced pension benefit to help Veterans pay for long-term care.
Health Serv Res 2021;
56:389-399. [PMID:
33634467 DOI:
10.1111/1475-6773.13636]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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.
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