JAMDA
Volume 8, Issue 8 , Pages 515-518 , October 2007

Drug Costs and Use in VHA Nursing Homes: A National Overview of Long-Stay Residents

  • Dustin D. French, PhD

      Affiliations

    • VISN-8 Patient Safety Center of Inquiry, James A. Haley VAMC, Tampa, FL
    • Corresponding Author InformationAddress correspondence to Dustin D. French, PhD, VISN-8 Patient Safety Center of Inquiry, 13000 Bruce B. Downs Boulevard (118M), Tampa, FL 33612.
  • ,
  • Robert R. Campbell, JD, MPH, PhD

      Affiliations

    • VISN-8 Patient Safety Center of Inquiry, James A. Haley VAMC, Tampa, FL
  • ,
  • Andrea M. Spehar, DVM, MPH, JD

      Affiliations

    • VISN-8 Patient Safety Center of Inquiry, James A. Haley VAMC, Tampa, FL
  • ,
  • Laurence Z. Rubenstein, MD, MPH

      Affiliations

    • UCLA David Geffen School of Medicine and the Director of the VA Greater Los Angeles Healthcare System (GLAHS) Geriatric Research, Education and Clinical Center (GRECC), Sepulveda and West Los Angeles Divisions, North Hills, CA
  • ,
  • Francesca E. Cunningham, PharmD

      Affiliations

    • VHA Center for Medication Safety, Pharmacy Benefits Management, and the University of Illinois at Chicago, Hines, IL.

References 

  1. Doshi JA, Shaffer T, Briesacher BA. National estimates of medication use in nursing homes: Findings from the 1997 Medicare current beneficiary survey and the 1996 medical expenditure survey. J Am Geriatr Soc. 2005;53:438–443
  2. Baugh DK, Pine PL, Blackwell S, et al. Medicaid prescription drug spending in the 1990s: A decade of change. Health Care Financ Rev. 2004;25:5–23
  3. French DD, Werner DC, Campbell RR, et al. A multivariate fall risk assessment model for VHA nursing homes using the Minimum Data Set. J Am Med Dir Assoc. 2007;8:115–122
  4. French DD, Campbell RR, Spehar AM, et al. How well do psychotropic medications match mental health diagnoses? (A national view of potential off-label prescribing in VHA nursing homes). Age Ageing. 2006;36:107–108
  5. Department of Veterans Affairs. VHA Directive 2005-060. 2005;December 7, Implementation of the Medicare Prospective Payment System (PPS) assessment form (MPAF). Available at: http://www1.va.gov/VHAPUBLICATIONS/ViewPublication.asp?pub_ID=1356. Accessed January 12, 2007.
  6. Department of Veterans Affairs. VHA Directive 2005-061. 2005;December 7, VA nursing home care unit (NHCU) admission criteria, service codes, and discharge criteria. Available at: http://www1.va.gov/geriatricsshg/docs/VANHCUadmission05.pdf. Accessed January 12, 2007.
  7. Department of Veterans Affairs. Resident Assessment Instrument Minimum Data Set (RAI/MDS) VHA Directive 2001-029, May 10, 2001. Available at: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=104. Accessed January 12, 2007.
  8. Centers for Medicare and Medicaid Services. Revised long-term facility resident assessment instrument user’s manual verions 2.0. 2006;Revised June. Available at: http://www.cms.hhs.gov/NursingHomeQualityInits/20_NHQIMDS20.asp#TopOfPage. Accessed January 12, 2007.
  9. Morris J, Hawes C, Murphy K, et al. Resident assessment instrument training manual and resource guide. National Technical Information Service, Springfield, VA: US Department of Health and Human Services, Health Care Financing Administration, January 1991.
  10. Morris J, Murphy K, Nonemaker S. Long Term Care Resident Assessment Instrument User’s Manual for Version 2.0. National Technical Information Service, Springfield, VA: US Department of Health and Human Services, Health Care Financing Administration, October 1995.
  11. Nonemaker S, Murphy K, Morris, J. Long Term Care Resident Assessment Instrument Training Materials for Version 2.0 (standardized training package), November 1995. Available at: http://www.interrai.org/section/view/?fnode=17. Accessed January 12, 2007.
  12. VIReC Research User Guide: VHA Decision Support System (DSS) Clinical National Data Extracts (NDES) FY2000-FY2004 Available at: http://www.virec.research.va.gov/References/RUG/RUG-DSS00-04.pdf. Accessed January 12, 2007.
  13. Trends and planning challenges to providing nursing home care to veterans. GAO-06-333T; January 2006. Available at: http://www.gao.gov/new.items/d06333t.pdf. Accessed January 12, 2007.
  14. GAO. VA long-term care: Oversight of nursing home program impeded by data gaps. GAO-05-65; Nov. 2004. Available at: http://www.gao.gov/new.items/d0565.pdf. Accessed January 12, 2007.
  15. National Formulary Questions. Available at: http://www.pbm.va.gov/natform/fequentlyasked.htm. Accessed January 17, 2007.
  16. PBM National Formulary. Available at: http://www.pbm.va.gov/NationalFormulary.aspx. Accessed January 17, 2007.
  17. SAS Language: Reference, Version 9. Cary, NC: SAS Institute; 2006;
  18. Sommers A, Cohen M, O’Malley M. Medicaid’s long-term care beneficiaries: An analysis of spending patterns. Kaiser Commission on Medicaid and the Uninsured. Available at: http://www.kff.org/medicaid/7576.cfm. Accessed January 19, 2007.
  19. Stuart B, Simoni-Wastila L, Baysac F, et al. Coverage and use of prescription drugs in nursing homes: Implications for the Medicare Modernization Act. Med Care. 2006;44:243–249
  20. Medicare Part D Versus Part B Coverage Issues. CMS. Available at: www.cms.hhs.gov/PrescriptionDrugCovGenIn/Downloads/PartBandPartDdoc_07.27.05.pdf. Accessed January 19, 2007.
  21. Edleman TS. Medicare prescription drug coverage for residents of nursing homes and assisted living facilities: Special problems and concerns. Henry J. Kaiser family Foundation. Available at: http://www.kff.org/medicare/7432.cfm. Accessed January 17, 2007.
  22. Congressional Budget Office (CBO). Prescription drug pricing in the private sector. January 2007. Available at: http://www.cbo.gov/ftpdocs/77xx/doc7715/01-03-PrescriptionDrug.pdf. Accessed January 24, 2007.

 The research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration (VHA). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

PII: S1525-8610(07)00129-6

doi: 10.1016/j.jamda.2007.02.001

JAMDA
Volume 8, Issue 8 , Pages 515-518 , October 2007