Details:

Alternative Title:
Prev Chronic Dis
Personal Author:
Maciejewski, Matthew L. ; Yancy, William S. ; Olsen, Maren ; Weidenbacher, Hollis J. ; Abbott, David ; ... More +
Maciejewski, Matthew L. ; Yancy, William S. ; Olsen, Maren ; Weidenbacher, Hollis J. ; Abbott, David ; Weinberger, Morris ; Datta, Santanu ; Kahwati, Leila C. Less -
Description:
Introduction

Overweight and obesity are public health issues in the United States, and veterans have a higher rate of overweight and obesity than the general population. Our objective was to examine whether copayment elimination increased use of a weight loss clinic by veterans.

Methods

We examined clinic use by 44,411 new patients seen in a Veterans Affairs (VA) MOVE! weight management clinic before the copayment elimination and clinic use by 64,398 new patients seen in the year after copayment elimination. We examined clinic use via mixed-effects models for patients who were already exempt from copayment and patients who were newly exempt from copayment. We used 2 outcomes before and after copayment elimination: 1) the ratio of number of clinic visits by new users with the mean number of MOVE! clinic visits by all users, and 2) the number of clinic visits by each new user in the 6 months after their first visit. All models were adjusted for patient and clinic factors.

Results

Among newly exempt patients, the clinic-standardized rate of new use increased by 2.2% after the copayment was eliminated but increased 12% among already exempt veterans. This finding was confirmed in adjusted analyses. Analysis of number of clinic visits adjusted for patient and clinic factors also found that exempt and nonexempt veterans had similar numbers of repeat clinic visits.

Conclusion

We saw an unexpected larger increase in demand among veterans who receive all VA care for free. These results suggest that VA should not assume that copayment reductions for selective preventive services will motivate patient change and achieve intended system-level outcomes.


Subject:
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Counseling
Deductibles And Coinsurance
Health Services Needs And Demand
Humans
Original Research
Weight Loss

Source:
Prev Chronic Dis. 10.
Document Type:
Journal Article
Collection(s):
Preventing Chronic Disease
Main Document Checksum:
[+]
urn:sha256:eaa195b19e3d94fe67ecdc2cb700eb0355953721dbd11ea9004c0acca9c5c1ee
File Type:

Supporting Files

• 	license.txt	txt
  	PCD-10-E49.nxml	txt

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