Table 2.
Estimates of Hazard Ratios (HRs) and 95% Confidence Intervals (CIs) of PCAFC Approval on Engagement in Vocational and Education Assistance Services, Results From Naïve and IV Models.
| Outcome Cohort | Sample size | Naïve HR [95% CI] | IV HR [95% CI] |
|---|---|---|---|
| Time to application to post-9/11 GI Billa | 9,776 | 0.94 [0.85, 1.03] | 0.93 [0.85, 1.05] |
| Time to application to VR&E | 9,390 | 0.84 [0.76, 0.93] | 0.84 [0.76, 0.93] |
| Time to first supported employment visit | 19,217 | 1.29 [1.00, 1.67] | 1.35 [1.14, 1.53] |
Note. PCAFC = Program of Comprehensive Assistance for Family Caregivers; IV = instrumental variable; VR&E = Vocational Rehabilitation and Education Program. Brackets indicate 95% confidence interval constructed using standard errors for IV models from 100 bootstrapped replications using sampling with replacement. Use of supported employment is defined as at least one documented session of supported employment. IV is defined as proportion in the sample who were accepted into PCAFC in the previous 6-month time period within each “home facility” in the two-stage residual inclusion (2SRI) results. Comparison group = Veterans of caregivers who applied to but were denied entry into PCAFC; treatment group = Veterans of caregivers approved into PCAFC.
N = 16 veterans were in a home “VAMC” that did not have any veterans in the sample applying for the post-9/11 GI Bill in the assessed timeframe and were excluded from the analysis.
All models controlled for indicator if approved for PCAFC, age, gender, marital status, whether the caregiver was a veteran (per VA electronic health records), veteran received a homeless diagnosis or clinic stop in year prior to and including application date, race, Hispanic/Latino ethnicity, veteran/caregiver relationship, any mental health visits in 6 months prior to PCAFC application, any primary care visits in 6 months prior to PCAFC application, enrollment priority group, service connected, physical comorbidities including: musculoskeletal disorders/diseases, pain (not including back or joint), joint pain (not including back), hyperlipidemia, hypertension, traumatic brain injury, obesity, headache, hearing (loss, pain, or other), diabetes, neoplasm, and chest pain/acute myocardial infarction, mental health comorbidities including: PTSD, depression, anxiety, tobacco use, alcohol or substance use disorder, other mental health, adjustment reaction, and bipolar disorder, non-VA insurance, means test status (must pay copay, copay unknown), lives within 30 miles of VAMC, Nosos score ≥1, fixed effects for 6-month application date time periods, fixed effect for VAMC. Supported employment models controlled for VISN and not VAMC because 16 “home” VAMCs did not have any veterans in the sample with supported employment use in the assessed timeframe.