Disability Compensation Related to Lower Hospitalizations Among Veterans With Diabetes

Findings showed disability compensation among Vietnam-era veterans with diabetes is associated with substantial declines in acute hospitalizations, but not connected to lower mortality.

With little knowledge on whether income assistance for adults with low income and disability improves health outcomes, researchers determined the correlation between eligibility for disability compensation and mortality and hospitalizations among Vietnam-era veterans with diabetes.
Vietnam-era veterans with diabetes in the Veterans Affairs Healthcare System were participated in a quasiexperimental cohort study which focused on a July 1, 2001, policy that expanded eligibility for disability compensation to veterans with “boots on the ground” (BOG) on the basis of a diagnosis of diabetes. “Not on ground” (NOG) veterans were ineligible.

Researchers estimated difference-in-differences during early (July 1, 2001 to December 31, 2007), middle (January 1, 2008-December 31, 2012), and later (January 1, 2013 to December 31, 2018) post-policy periods.

Of 14,247 BOG veterans included in the study the mean age at baseline was 51.2 years, 25.7% were Black, 3.3% were Hispanic, 63.6% were White, and 6.9% were of another race. There were 56,224 NOG veterans included with a mean age of 54.2 years, 21.7% were Black, 2.1% were Hispanic, 67.1% were White, and 8.2% were reported another race.

BOG veterans received $8025, $14,412, and $17162 more in annual disability compensation during the early, middle, and later post-policy periods when compared to NOG veterans.

Researchers determined that prepolicy mortality rates were 3.04% for BOG and 3.56% for NOG veterans, with adjusted difference-in-differences of .24 percentage points (95% CI, -.08 to .52), -.08% (95% CI, -.40 to .24), and -.08% (95% CI, -.48 to .36), during the early, middle, and later post-policy periods resulting in unchanged annual mortality rates.

“Among 3623 BOG veterans and 19,174 NOG veterans with Medicare coverage in 1999, a population whose utilization could be completely observed in our data, BOG veterans experienced reductions of -7.52 hospitalizations per 100 person-years (95% CI, -13.12 to -1.92) during the early, -10.12 (95% CI, -17.28 to -3.00) in the middle, and -15.88 (95% CI, -24.00 to -7.76) in the later periods,” wrote researchers. “These estimates represent relative declines of 10%, 13%, and 21%.

Study authors concluded that veterans’ disability compensation payments may have important health benefits.

Reference:
Trivedi AN, Jiang L, Miller DR, et al. Association of disability compensation with mortality and hospitalizations among Vietnam-era veterans with diabetes. JAMA Intern Med. 2022;182(7):757-765. doi:10.1001/jamainternmed.2022.2159