A Comparative Analysis of VHA, Non-VHA, and Overall Outpatient Treatment Use Intensity Among Older U.S. Veterans Denied or Awarded VA Service-Connected Disability Compensation

Poorer health is often associated with greater healthcare use among the general population. In contrast, while many veterans denied VA disability compensation ("denied applicants") are as impaired as those awarded VA disability compensation ("awarded applicants"), studies suggest that these veterans may nevertheless utilize less VHA healthcare. Whether they concurrently utilize less non-VHA, and overall healthcare, however, remains a critical, unresolved issue. The 2001 National Survey of Veterans was used to examine VHA, non-VHA, and overall outpatient healthcare treatment use intensity during the previous 12 months among veterans denied or awarded VA disability compensation. Results: Denied applicants were significantly more likely than those awarded to have not used any VHA outpatient healthcare during the previous 12 months (OR=2.45, 95% CI: 1.24, 4.81). Moreover, while not statistically significant, point estimates consistently suggested that denied may have concurrently used more non-VHA, and overall outpatient healthcare than awarded. It appears veterans denied VA disability compensation are forgoing VHA outpatient healthcare services, perhaps in favor of non-VHA outpatient healthcare services. While this result may be consistent with the intent of VA service-connected disability policy, further analysis is necessary to confirm adequate access to healthcare for denied veterans.