{"doi":"10.1111/1475-6773.70013","title":"Veterans' Behavioral Health Hospitalizations and Outcomes in\n                    <scp>VA</scp>\n                    Versus Non‐\n                    <scp>VA</scp>\n                    Hospitals","abstract":"<jats:title>ABSTRACT</jats:title>\n                  <jats:sec>\n                    <jats:title>Objective</jats:title>\n                    <jats:p>To compare outcomes for Department of Veterans Affairs (VA) enrollees' behavioral health (BH) hospitalizations by source (VA‐direct, VA‐purchased community care (CC), Medicaid, Medicare, private insurance, and other payers).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Setting and Design</jats:title>\n                    <jats:p>We conducted a retrospective, longitudinal study with VA enrollees from 2015 to 2017 to examine differences in BH hospitalization outcomes by source. We used generalized linear models with clustered standard errors to predict length of stay (LOS), cost, and 30‐day readmission.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Analytic Sample</jats:title>\n                    <jats:p>We studied 124,609 BH hospitalizations of 77,299 VA enrollees in 11 geographically diverse states.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings</jats:title>\n                    <jats:p>\n                      Predicted mean LOS (9.03 days, 95% CI 8.92–9.14 days;\n                      <jats:italic>p</jats:italic>\n                       &lt; 0.001) and cost ($17,608, 95% CI $17,347–$17,870;\n                      <jats:italic>p</jats:italic>\n                       &lt; 0.001) were highest for VA‐direct hospitalizations, while the mean readmission rate was lowest for VA‐direct hospitalizations (17.36%, 95% CI 17.03%–17.69%;\n                      <jats:italic>p</jats:italic>\n                       &lt; 0.001). Average marginal effects for each non‐VA hospitalization source were statistically significantly different from VA‐direct hospitalizations (\n                      <jats:italic>p</jats:italic>\n                       &lt; 0.001): between 2.13 and 2.90 days less for LOS, $11,141 to $12,144 less for cost, and 2.71% to 5.18% higher for readmission rate.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>The majority of BH hospitalizations were in VA‐direct care (56%), with 44% provided in locations outside VA hospitals: Medicare (19%), CC (7%), private insurance (7%), other payers (6%), and Medicaid (5%). There are trade‐offs between BH hospitalizations provided in VA‐direct care (lowest readmission rate, highest LOS and costs) and other sources.</jats:p>\n                  </jats:sec>","journal":"Health Services Research","year":2026,"id":653642,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":493694,"name":"Ciaran S. Phibbs","orcid":"0000-0002-4353-3507","position":1,"is_corresponding":false},{"id":409458,"name":"Michael Ong","orcid":"0000-0001-8530-7754","position":2,"is_corresponding":false},{"id":1211465,"name":"Yue Zhang","orcid":"0009-0000-2465-4621","position":3,"is_corresponding":false},{"id":1705488,"name":"Adam Chow","orcid":null,"position":4,"is_corresponding":false},{"id":1499718,"name":"Jean Yoon","orcid":"0000-0001-8565-2881","position":5,"is_corresponding":false},{"id":479565,"name":"Megan E. Vanneman","orcid":"0000-0003-3013-1362","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Veterans' Behavioral Health Hospitalizations and Outcomes in\n                    <scp>VA</scp>\n                    Versus Non‐\n                    <scp>VA</scp>\n                    Hospitals","abstract":"<jats:title>ABSTRACT</jats:title>\n                  <jats:sec>\n                    <jats:title>Objective</jats:title>\n                    <jats:p>To compare outcomes for Department of Veterans Affairs (VA) enrollees' behavioral health (BH) hospitalizations by source (VA‐direct, VA‐purchased community care (CC), Medicaid, Medicare, private insurance, and other payers).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Setting and Design</jats:title>\n                    <jats:p>We conducted a retrospective, longitudinal study with VA enrollees from 2015 to 2017 to examine differences in BH hospitalization outcomes by source. We used generalized linear models with clustered standard errors to predict length of stay (LOS), cost, and 30‐day readmission.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Analytic Sample</jats:title>\n                    <jats:p>We studied 124,609 BH hospitalizations of 77,299 VA enrollees in 11 geographically diverse states.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings</jats:title>\n                    <jats:p>\n                      Predicted mean LOS (9.03 days, 95% CI 8.92–9.14 days;\n                      <jats:italic>p</jats:italic>\n                       &lt; 0.001) and cost ($17,608, 95% CI $17,347–$17,870;\n                      <jats:italic>p</jats:italic>\n                       &lt; 0.001) were highest for VA‐direct hospitalizations, while the mean readmission rate was lowest for VA‐direct hospitalizations (17.36%, 95% CI 17.03%–17.69%;\n                      <jats:italic>p</jats:italic>\n                       &lt; 0.001). Average marginal effects for each non‐VA hospitalization source were statistically significantly different from VA‐direct hospitalizations (\n                      <jats:italic>p</jats:italic>\n                       &lt; 0.001): between 2.13 and 2.90 days less for LOS, $11,141 to $12,144 less for cost, and 2.71% to 5.18% higher for readmission rate.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>The majority of BH hospitalizations were in VA‐direct care (56%), with 44% provided in locations outside VA hospitals: Medicare (19%), CC (7%), private insurance (7%), other payers (6%), and Medicaid (5%). There are trade‐offs between BH hospitalizations provided in VA‐direct care (lowest readmission rate, highest LOS and costs) and other sources.</jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"40699186","pmcid":null,"openalex_id":"https://openalex.org/W4412599103","authors":[],"funders":[{"funder_name":"U.S. Department of Veterans Affairs","grant_id":"IHX002653‐01A1","title":null},{"funder_name":"Health Services Research and Development","grant_id":"1IK2HX002625","title":null},{"funder_name":"HSRD VA","grant_id":"I01 HX002653","title":null},{"funder_name":"HSRD VA","grant_id":"IK2 HX002625","title":null},{"funder_name":"Health Services Research and Development (HSR&D), Veterans Health Administration (VHA), Department of Veterans Affairs (VA)","grant_id":"IHX002653-01A1","title":null}],"total_grants":5,"fwci":0.0,"citation_percentile":0.26440266,"influential_citations":0,"citation_trend":[],"oa_status":"green","license":"public-domain","oa_locations":[{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12857467/","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12857467/","host_type":"repository"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/1475-6773.70013","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/full-xml/10.1111/1475-6773.70013","host_type":"publisher"},{"url":"https://doi.org/10.1111/1475-6773.70013","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/40699186","host_type":"repository"}],"fields_of_study":["Primary Care and Health Outcomes","Chronic Disease Management Strategies","Heart Failure Treatment and Management","Humans","United States","Male","Retrospective Studies","Female","Hospitalization","Length of Stay","Longitudinal Studies","Patient Readmission","Middle Aged","Aged","Veterans","Medicare","Medicaid","United States Department of Veterans Affairs","Adult","Hospitals, Veterans","Mental Disorders"],"mesh_terms":["Adult","Aged","Mental Disorders","Female","Medicare","Hospitalization","Hospitals, Veterans","Humans","Length of Stay","Longitudinal Studies","Male","Medicaid","Middle Aged","Patient Readmission","Retrospective Studies","United States","United States Department of Veterans Affairs","Veterans"],"keywords":["Medicaid","Medicine","Veterans Affairs","Health insurance","Private insurance","Emergency medicine","Health care","Retrospective cohort study","Medicare Advantage","Demography","Internal medicine","Family medicine","Gerontology","Veterans","Health Policy","Hospitalizations","Behavioral Health"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T23:35:21.753707Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}