Leveraging Electronic Health Records to Assess Residential Mobility Among Veterans in the Veterans Health Administration

• Published in: Medical care Vol. 62; no. 7; pp. 458 - 463
• Main Authors: Wang, Karen H, Hendrickson, Zoé M, Miller, Mary L, Abel, Erica A, Skanderson, Melissa, Erdos, Joseph, Womack, Julie A, Brandt, Cynthia A, Desai, Mayur, Han, Ling
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins Ovid Technologies 01-07-2024
• Subjects: Adult; Aged; Clinical outcomes; Cross-Sectional Studies; Electronic health records; Electronic Health Records - statistics & numerical data; Electronic medical records; Female; Health care; Health services utilization; Humans; Male; Middle Aged; Mobility; Patients; Population Dynamics - statistics & numerical data; Regression analysis; Regression models; Sociodemographics; Substance use; United States; United States Department of Veterans Affairs; Veterans - statistics & numerical data; United States
• ISSN: 0025-7079; 1537-1948; 1537-1948
• DOI: 10.1097/MLR.0000000000002017

Residential mobility, or a change in residence, can influence health care utilization and outcomes. Health systems can leverage their patients' residential addresses stored in their electronic health records (EHRs) to better understand the relationships among patients' residences, mobility, and health. The Veteran Health Administration (VHA), with a unique nationwide network of health care systems and integrated EHR, holds greater potential for examining these relationships.
We conducted a cross-sectional analysis to examine the association of sociodemographics, clinical conditions, and residential mobility. We defined residential mobility by the number of VHA EHR residential addresses identified for each patient in a 1-year period (1/1-12/31/2018), with 2 different addresses indicating one move. We used generalized logistic regression to model the relationship between a priori selected correlates and residential mobility as a multinomial outcome (0, 1, ≥2 moves).
In our sample, 84.4% (n=3,803,475) veterans had no move, 13.0% (n=587,765) had 1 move, and 2.6% (n=117,680) had ≥2 moves. In the multivariable analyses, women had greater odds of moving [aOR=1.11 (95% CI: 1.10,1.12) 1 move; 1.27 (1.25,1.30) ≥2 moves] than men. Veterans with substance use disorders also had greater odds of moving [aOR=1.26 (1.24,1.28) 1 move; 1.77 (1.72,1.81) ≥2 moves].
Our study suggests about 16% of veterans seen at VHA had at least 1 residential move in 2018. VHA data can be a resource to examine relationships between place, residential mobility, and health.