Using GIS to Profile Health-Care Costs of VA Quality-Enhancement Research Initiative Diseases

  • Authors:

  • Wei Yu;Diane Cowper;Magdalena Berger;Mark Kuebeler;Joe Kubal;Larry Manheim

  • Affiliations:

  • Health Economics Resource Center, VA Palo Alto Health Care System, Palo Alto, California. Center for Health Policy and Center for Primary Care Outcomes and Research, Stanford University, Stanford, ...;Malcolm Randall VA Medical Center, Gainesville, Florida;Health Economics Resource Center, VA Palo Alto Health Care System, Palo Alto, California;VA HSR&D Center of Excellence, Houston, Texas;VA Cooperative Studies Program Coordinating Center, Hines, Illinois;VA Midwest Center for Health Services and Policy Research, Hines, Illinois. Institute for Health Services Research and Policy Studies, Northwestern University, Chicago, Illinois

  • Venue:
  • Journal of Medical Systems
  • Year:
  • 2004

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Abstract

The Health Services Research and Development (HSR&D) Service at the Department of Veterans Affairs (VA) Health Care System launched a Quality Enhancement Research Initiative (QUERI) in 1998. This study estimated health-care costs of nine diseases under the QUERI project and analyzed geographic differences in health-care costs and utilization across 22 VA Integrated Service Networks (VISNs), using a geographic information system (GIS). Patients with these diseases were identified from diagnoses recorded between October 1999 and September 2000. Annual health-care costs for each disease were estimated in four categories: inpatient medical or surgical, other inpatient, outpatient, and outpatient pharmacy. Geographic differences of costs and health-care utilization across the 22 VISNs for chronic heart failure, diabetes, and spinal-cord injury were mapped using a GIS package. Average costs and patterns of health-care utilization varied substantially across the 22 VISNs. The observed differences in health-care utilization across geographic regions raised questions for further investigation.