Informal Caregiver Support Policies Change Use of Vocational Assistance Services for Individuals With Disabilities.

Shepherd-Banigan M, Smith VA, Stechuchak KM, Van Houtven CH. Informal Caregiver Support Policies Change Use of Vocational Assistance Services for Individuals With Disabilities. Medical care research and review : MCRR. 2022 Apr 1; 79(2):218-232.

Related HSR&D Project(s)

• SDR 16-194 – Evaluation of Veteran Directed Home and Community Based Services
• PPO 20-342 – The Impact of the COVID-19 Pandemic on Veteran Caregivers: A Mixed Methods Study to inform the VA Caregiver Support System
• CDA 17-006 – Increasing mental health services use through enabling resources & family support
• IIR 15-379 – Quality of Care and Patient Experience in GeriPACT: A Comparative Effectiveness Study

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Abstract:

Support policies for caregivers improves care-recipient access to care and effects may generalize to nonhealth services. Using administrative data from the U.S. Department of Veterans Affairs (VA) for veterans < 55 years, we assessed the association between enrollment in a VA caregiver support program and veteran use of vocational assistance services: the post-9/11 GI Bill, VA vocational rehabilitation and employment (VRandE), and supported employment. We applied instrumental variables to Cox proportional hazards models. Caregiver enrollment in the program increased veteran supported employment use (hazard ratio = 1.35, 95% confidence interval [1.14, 1.53]), decreased VRandE use (hazard ratio = 0.84, 95% confidence interval [0.76, 0.92]), and had no effect on the post-9/11 GI Bill. Caregiver support policies could increase access to some vocational assistance for individuals with disabilities, particularly supported employment, which is integrated into health care. Limited coordination between health and employment sectors and misaligned incentives may have inhibited effects for the post-9/11 GI Bill and VRandE.