Is There a VA Advantage? Evidence from Dually Eligible Veterans

• 成果类型: Article
• 署名作者: Chan, David C.; Card, David; Taylor, Lowell
• 署名单位: US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Palo Alto Health Care System; Stanford University; National Bureau of Economic Research; University of California System; University of California Berkeley; Carnegie Mellon University
• 刊物名称: AMERICAN ECONOMIC REVIEW
• ISSN/ISSBN: 0002-8282
• DOI: 10.1257/aer.20211638
• 发表日期: 2023
• 页码: 3003-3043
• 关键词: health-care; information-technology; medicare; Hospitals; QUALITY; mortality; COSTS; performance; COMPETITION; EQUATIONS

摘要

We study public versus private provision of health care for veterans aged 65 and older who may receive care provided by the US Department of Veterans Affairs (VA) and in private hospitals financed by Medicare. Utilizing the ambulance design of Doyle et al. (2015), we find that the VA reduces 28- day mortality by 46 percent ( 4.5 percentage points) and that these survival gains are persistent. The VA also reduces 28- day spending by 21 percent and delivers strikingly different reported services relative to private hospitals. We find suggestive evidence of complementarities between continuity of care, health IT, and integrated care.