COMPARISON OF UTILIZATION AND COST AMONG CONTRACT ADULT DAY HEALTH-CARE, VA ADULT DAY HEALTH-CARE, AND CUSTOMARY CARE

The contract ADHC evaluation compared the utilization and costs of pat ients assigned to contract ADHC with patients assigned to VA-ADHC care or customary care in the VA-ADHC evaluation. The ADHC costs per patie nt day were lower on average in the contract sites than in the VA-ADHC sites, although they were similar to the costs at 2 of the 4 VA-ADHCs . The contract site patients received significantly more days of ADHC care, offsetting their lower cost per day. Contract site patients had significantly fewer VA clinic visits and VA nursing home admissions th an did patients in the VA-ADHC or customary care groups. Patients at t he contract sites also had significantly fewer days of nursing home ca re than did the customary care group patients. Propensity scores based on intake characteristics were used to adjust for initial differences between the patients in the 2 evaluations. After adjustment, the tota l cost of care for contract ADHC patients was found to be significantl y higher than the cost for customary care patients, but no significant difference was found between contract ADHC patients and VA-ADHC patie nts.