Chronic Wound Care Utilization Among Veterans Using VHA And Medicare

ASU Author/Contributor (non-ASU co-authors, if there are any, appear on document)
Erin Bouldin, Assistant Professor, PhD (Creator)
Appalachian State University (ASU )
Web Site:

Abstract: Veterans who use the Veterans Health Administration (VHA) also may use Medicare coverage for treatment outside VHA. Using multiple health care systems introduces fragmentation and may increase utilization. The purpose of this study was to compare chronic wound care utilization among VHA-Medicare dual system users and VHA-exclusive users. Using data from VHA chart review and Medicare claims, we conducted a retrospective cohort study of 203 Medicare-enrolled VHA users with an incident, chronic lower limb wound between October 1, 2006 and September 30, 2007 and followed them for up to one year. We identified all VHA and Medicare wound-care visits during the wound episode. 19.7% of the cohort was dual users. Dual users had higher observed wound care utilization than VHA-exclusive users (11.9 versus 7.6 outpatient visits [p = 0.002] and 1.6 versus 0.7 inpatient stays [p = 0.0008]). After adjusting for covariates including wound duration, dual users were predicted to have 8.6 outpatient wound care visits and 1.1 inpatient wound care stays while VHA-exclusive users were predicted to have 7.0 (p = 0.07) outpatient visits and 0.7 (p = 0.05) inpatient stays. In conclusion, dual use contributes to higher wound care utilization potentially because of longer wound duration.

Additional Information

Bouldin ED, Wong ES, Liu CF, Littman AJ, Taylor LL, Rice K, Reiber GE (2017). "Chronic Wound Care Utilization Among Veterans Using VHA And Medicare." Wound Medicine 2017; 17:1-6. Publisher version of record available at:
Language: English
Date: 2017
Chronic wound, Lower extremity, Medicare, Ulcer, Utilization, Veterans

Email this document to