Journal of Community Health

, Volume 37, Issue 4, pp 882–887 | Cite as

Factors Associated with Program Utilization of Radiation Therapy Treatment for VHA and Medicare Dually Enrolled Patients

  • Dustin D. French
  • Douglas D. Bradham
  • Robert R. Campbell
  • David A. Haggstrom
  • Laura J. Myers
  • Neale R. Chumbler
  • Michael P. Hagan
Original Paper


We examine how distance to a Veterans Health Administration (VHA) facility, patient hometown classification (e.g., small rural town), and service-connected disability are associated with veterans’ utilization of radiation therapy services across the VHA and Medicare. In 2008, 45,914 dually-enrolled veteran patients received radiation therapy. Over 3-quarters (35,513) of the patients received radiation therapy from the Medicare program. Younger age, male gender, shorter distance to a VHA facility, and VHA priority or disability status increased the odds of utilizing the VHA. However, veterans residing in urban areas were less likely to utilize the VHA. Urban dwelling patients’ utilization of Medicare instead of the VHA suggests a complex decision that incorporates geographic access to VHA services, financial implications of veteran priority status, and the potential availability of multiple sources of radiation therapy in competitive urban markets.


Access Medicare Veterans Dually eligible Radiation 



This project was supported by the Department of Veterans Affairs Health Services Research and Development Service (VA HSR&D; PPO 10-095). Special thanks to Patricia J. Gheen, National Director of VHA Fee-Basis and Purchased Care, for her insight and expertise.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Dustin D. French
    • 1
  • Douglas D. Bradham
    • 3
  • Robert R. Campbell
    • 2
  • David A. Haggstrom
    • 1
  • Laura J. Myers
    • 1
  • Neale R. Chumbler
    • 1
  • Michael P. Hagan
    • 4
    • 5
  1. 1.Department of General Internal Medicine and Geriatrics, VA Center of Excellence on Implementing Evidence Based PracticeRegenstrief Institute Inc., Indiana University School of MedicineIndianapolisUSA
  2. 2.VA Center of Excellence, Maximizing Rehabilitation OutcomesJames A. Haley Veterans HospitalTampaUSA
  3. 3.Department of Preventive Medicine and Public HealthRobert J. Dole VA and the University of Kansas School of MedicineWichitaUSA
  4. 4.Department of Radiation OncologyVirginia Commonwealth UniversityRichmondUSA
  5. 5.Department of Veterans Affairs, Veterans Health AdministrationDirector of the National Radiation Oncology Program OfficeRichmondUSA

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