Health Services Research & Development

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2006 HSR&D National Meeting Abstract


2002 — Advances in Utilization and Cost Data

Author List:
Smith MW (HERC)
Chen S (HERC)
Wagner TH (HERC)
Phibbs TH (HERC)
Barnett PG (HERC)

Objectives:
To introduce national VA datasets and to present comparisons of alternative sources of VA cost estimates. This workshop will feature four presentations: a comparison of DSS intermediate product data and DSS national data extracts; an explanation of the Fee Basis data with recommendations for use; an explanation of the National Prosthetics Patient Database with recommendations for use; and a comparison of alternative costs for VA care in the DSS national data extracts and the HERC average cost data. DSS national data extracts (NDE) are encounter-level data. The DSS intermediate product data (IPD) contain detailed information on the components of each encounter, but their enormous size and detail make them more difficult to use, particularly for the inexperienced researcher. We will discuss how to use the intermediate product data and present results from a comparison of the NDE and IPD for patients enrolled in a VA clinical trial. The Fee Basis data record care provided at VA expense outside of VA facilities. They represent an important source of information on community nursing homes and state veterans homes, emergency care for veterans, and infrequent procedures provided on contract. We will present the first ever guidebook for using the Fee Basis data, explaining their structure and contents and offering suggestions for use. The prosthetics and sensory aids service (PSAS) provides millions of items each year, from glasses and hearing aids to drug-eluting stents and home-oxygen supplies. The National Prosthetics Patient Database (NPPD) is intended to record all such items. It will be critical to health services research on veterans with polytrauma/blast-related injuries, many of whom use prosthetics. We will present findings and recommendations from the first-ever study of NPPD for research use. The HERC average cost data and the DSS NDEs provide alternative cost estimates for VA care. Researchers often wonder which is most appropriate for their projects. We will present recommendations based on a study comparing costs in the two datasets. Attendees will be able to apply knowledge from this workshop to a wide variety of health services and health economic projects.

Methods:
PowerPoint presentation with handouts followed by a Q&A session.

Results:
Health services researchers studying the use or cost of VA health care, or care at outside facilities paid by VA.

Implications:
The workshop assumes basic familiarity with national VA utilization datasets such as OPC/PTF and DSS national data extracts. No familiarity with Fee Basis or NPPD data is assumed.

Impacts: