Chronic Condition Burden by Veteran Status, Veterans Health Administration Enrollment, and Age Using Nationally Representative Survey Data.

IF 2.8 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Medical Care Pub Date : 2025-07-01 Epub Date: 2025-05-06 DOI:10.1097/MLR.0000000000002159

Neetu Chawla, Diana J Govier, Claire Than, Danielle Rose, Denise M Hynes, Katherine J Hoggatt, Elizabeth M Yano

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引用次数: 0

Abstract

Background: Historically, US Veterans have reported higher chronic disease burden than non-Veterans. However, whether Veteran and Veterans Affairs (VA) coverage status continue to be associated with chronic disease burden or how these associations vary by age, especially among younger Veterans, is unknown.

Objective: To examine the number of chronic conditions among male Veterans with and without VA coverage, and male non-Veterans, overall and by age group.

Design and participants: Using 2018 National Health Interview Survey data, our sample included 2301 male Veterans and 9243 male non-Veterans.

Main measures: The primary outcome was a number of chronic conditions, measured as a count (range 0-15) and categorically (0, 1, 2, 3+). We created a 3-category main independent variable (Veteran with VA coverage, Veteran without VA coverage, non-Veteran). Generalized linear regression models were used to estimate relationships between Veteran and VA coverage status and count of chronic conditions, overall and by age group (18-44, 45-64, 65+), adjusting for sociodemographic characteristics.

Key results: Veterans with VA coverage, Veterans without VA coverage, and non-Veterans had an age-standardized mean of 1.44, 1.16, and 1.09 chronic conditions, respectively. In adjusted analyses, Veterans with VA coverage had 0.36 (95% CI: 0.25-0.46) more conditions and Veterans without VA coverage had 0.12 (95% CI: 0.04-0.21) more conditions compared with non-Veterans. In age-stratified analyses, Veterans with VA coverage aged 18-44 had 0.22 (95% CI: 0.06-0.38) more conditions; 45-64, 0.71 (95% CI: 0.41-0.99) more conditions; and 65+, 0.38 (95% CI: 0.18-0.57) more conditions compared with similar-aged non-Veterans.

Conclusions: Veterans with VA coverage had the greatest number of chronic conditions, including when stratified by age group.

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慢性病负担由退伍军人身份，退伍军人健康管理登记和年龄使用全国代表性调查数据。

背景：历史上，美国退伍军人报告的慢性疾病负担高于非退伍军人。然而，退伍军人和退伍军人事务（VA）的覆盖状况是否继续与慢性疾病负担相关，或者这些关联如何随年龄变化，特别是在年轻退伍军人中，尚不清楚。目的：调查有退伍军人保险和没有退伍军人保险的男性退伍军人以及男性非退伍军人的慢性疾病数量，总体上和按年龄组分列。设计和参与者：使用2018年全国健康访谈调查数据，我们的样本包括2301名男性退伍军人和9243名男性非退伍军人。主要测量指标：主要结果是一些慢性疾病，以计数（范围0-15）和分类（0,1,2,3 +）来测量。我们创建了一个3类主要自变量（有退伍军人保险，没有退伍军人保险，非退伍军人）。使用广义线性回归模型估计退伍军人和退伍军人保险状况与慢性病数量之间的关系，总体上和按年龄组（18-44岁、45-64岁、65岁以上），并根据社会人口统计学特征进行调整。关键结果：有退伍军人保险的退伍军人、没有退伍军人保险的退伍军人和非退伍军人的慢性疾病年龄标准化平均值分别为1.44、1.16和1.09。在调整分析中，与非退伍军人相比，有退伍军人保险的退伍军人有0.36 （95% CI: 0.25-0.46）多的病症，而没有退伍军人保险的退伍军人有0.12 （95% CI: 0.04-0.21）多的病症。在年龄分层分析中，18-44岁退伍军人的病情多0.22 (95% CI: 0.06-0.38)；45-64, 0.71 (95% CI: 0.41-0.99)；65岁以上，与年龄相近的非退伍军人相比，病情增加0.38 （95% CI: 0.18-0.57）。结论：有退伍军人保险的退伍军人有最多的慢性疾病，包括按年龄组分层。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Care 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

3.30%

发文量

228

审稿时长

3-8 weeks

期刊介绍： Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services.