Health Care Expenditures for Urban and Rural Veterans in Veterans Health Administration Care

Objective To compare Veterans Health Administration (VA) patients, non-VA-using veterans, and nonveterans, separated by urban/rural residence and age group, on their use of major categories of medical care and payment sources. Data Source Expenditures for health care-using men in Medical Expenditure Panel Surveys from 1996 through 2004. Study Design Retrospective, cross-sectional analysis. Data Collection/Extraction Methods Controlling for demographics, health status, and insurance, we compared groups on population-weighted expenditures for inpatient, hospital-based outpatient, office-based, pharmacy, and other care, by major payers (self/family, private insurance, Medicare, other sources, and VA). Results VA users received most of their health care outside of the VA system, paid through private insurance or Medicare; self-payments were substantial. VA users under 65 reported worse health if they were rural residents but also lower expenditures overall and less care through private insurance. Conclusions VA health care users get most of their medical care from non-VA providers. Working-age VA users have less insurance coverage and rely more on VA care if they live in rural areas.