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  Appendices

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> **Appendix 1**

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  Medical Care

  Appropriation & Medical Consumer Price Index

  FISCAL YEARS 1980 - 1995
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<table>
<colgroup>
<col style="width: 6%" />
<col style="width: 12%" />
<col style="width: 7%" />
<col style="width: 8%" />
<col style="width: 10%" />
<col style="width: 9%" />
<col style="width: 8%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 5%" />
<col style="width: 6%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="14">MEDICAL CARE APPROPRIATION AND MEDICAL CONSUMER PRICE
INDEX</td>
</tr>
<tr class="even">
<td colspan="14">FISCAL YEARS 1980 - 1995</td>
</tr>
<tr class="odd">
<td></td>
<td>ACTUAL</td>
<td></td>
<td>MED.CPI-U</td>
<td>UNIQUE</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="4">NUMBER OF FACILITIES</td>
</tr>
<tr class="even">
<td>FISCAL</td>
<td>APPROPRIATION</td>
<td>MEDICAL</td>
<td>ADJUSTED</td>
<td>INDIVIDUALS</td>
<td>INPATIENT</td>
<td>OUTPAT.</td>
<td>TOTAL</td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td>OP.</td>
</tr>
<tr class="odd">
<td>YEAR</td>
<td>($ 000)</td>
<td>CPI-U</td>
<td>APPROP.1/</td>
<td><u>2/</u></td>
<td>EPISODES 3/</td>
<td>VISITS</td>
<td>EPISODES</td>
<td colspan="2">FTE</td>
<td><p>HOSP</p>
<p>5/</p></td>
<td>NURSING</td>
<td>DOM</td>
<td>CLINICS</td>
</tr>
<tr class="even">
<td>1980</td>
<td>5,832,039</td>
<td>10.73%</td>
<td>5,832,039</td>
<td></td>
<td>1,159,028</td>
<td>18,204,000</td>
<td>19,363,028</td>
<td colspan="2">185,698</td>
<td>172</td>
<td>92</td>
<td>16</td>
<td>227</td>
</tr>
<tr class="odd">
<td>1981</td>
<td>6,339,396</td>
<td>10.33%</td>
<td>6,434,489</td>
<td></td>
<td>1,159,287</td>
<td>18,165,000</td>
<td>19,324,287</td>
<td colspan="2">184,865</td>
<td>172</td>
<td>96</td>
<td>16</td>
<td>226</td>
</tr>
<tr class="even">
<td>1982</td>
<td>7,101,028</td>
<td>11.89%</td>
<td>7,199,550</td>
<td></td>
<td>1,159,317</td>
<td>18,202,000</td>
<td>19,361,317</td>
<td colspan="2">186,836</td>
<td>172</td>
<td>98</td>
<td>16</td>
<td>226</td>
</tr>
<tr class="odd">
<td>1983</td>
<td>7,773,254</td>
<td>9.78%</td>
<td>7,903,666</td>
<td></td>
<td>1,199,434</td>
<td>18,754,000</td>
<td>19,953,434</td>
<td colspan="2">188,713</td>
<td>172</td>
<td>99</td>
<td>16</td>
<td>226</td>
</tr>
<tr class="even">
<td>1984</td>
<td>8,244,414</td>
<td>6.37%</td>
<td>8,407,130</td>
<td></td>
<td>1,207,690</td>
<td>18,836,000</td>
<td>20,043,690</td>
<td colspan="2">190,463</td>
<td>172</td>
<td>105</td>
<td>16</td>
<td>226</td>
</tr>
<tr class="odd">
<td>1985</td>
<td>8,971,169</td>
<td>6.11%</td>
<td>8,920,806</td>
<td></td>
<td>1,224,010</td>
<td>19,831,000</td>
<td>21,055,010</td>
<td colspan="2">193,828</td>
<td>172</td>
<td>115</td>
<td>16</td>
<td>226</td>
</tr>
<tr class="even">
<td>1986</td>
<td>9,130,137</td>
<td>7.25%</td>
<td>9,567,564</td>
<td></td>
<td>1,248,010</td>
<td>20,437,000</td>
<td>21,685,010</td>
<td colspan="2">194,453</td>
<td>172</td>
<td>117</td>
<td>16</td>
<td>229</td>
</tr>
<tr class="odd">
<td>1987</td>
<td>9,728,303</td>
<td>7.05%</td>
<td>10,242,077</td>
<td></td>
<td>1,247,595</td>
<td>21,890,000</td>
<td>23,137,595</td>
<td colspan="2">194,459</td>
<td>172</td>
<td>117</td>
<td>17</td>
<td>228</td>
</tr>
<tr class="even">
<td>1988</td>
<td>10,151,387</td>
<td>6.34%</td>
<td>10,891,425</td>
<td></td>
<td>1,263,235</td>
<td>23,232,000</td>
<td>24,495,235</td>
<td colspan="2">193,798</td>
<td>172</td>
<td>119</td>
<td>26</td>
<td>233</td>
</tr>
<tr class="odd">
<td>1989</td>
<td>10,887,671</td>
<td>7.22%</td>
<td>11,677,786</td>
<td>2,690,194</td>
<td>1,186,840</td>
<td>22,643,000</td>
<td>23,829,840</td>
<td colspan="2">191,801</td>
<td>172</td>
<td>122</td>
<td>28</td>
<td>339</td>
</tr>
<tr class="even">
<td>1990</td>
<td>11,436,306</td>
<td>8.84%</td>
<td>12,710,102</td>
<td>2,654,512</td>
<td>1,148,652</td>
<td>22,602,000</td>
<td>23,750,652</td>
<td colspan="2">193,821</td>
<td>172</td>
<td>126</td>
<td>32</td>
<td>339</td>
</tr>
<tr class="odd">
<td>1991</td>
<td>12,335,330</td>
<td>9.11%</td>
<td>13,867,992</td>
<td>2,645,860</td>
<td>1,105,576</td>
<td>23,039,000</td>
<td>24,144,576</td>
<td colspan="2">196,103</td>
<td>172</td>
<td>127</td>
<td>35</td>
<td>341</td>
</tr>
<tr class="even">
<td>1992</td>
<td>13,625,685</td>
<td>7.67%</td>
<td>14,931,667</td>
<td>2,726,899</td>
<td>1,085,126</td>
<td>24,195,000</td>
<td>25,280,126</td>
<td colspan="2">199,811</td>
<td>171</td>
<td>129</td>
<td>35</td>
<td>362</td>
</tr>
<tr class="odd">
<td>1993</td>
<td>14,642,723</td>
<td>6.29%</td>
<td>15,870,869</td>
<td>2,764,858</td>
<td>1,075,111</td>
<td>24,406,000</td>
<td>25,481,111</td>
<td colspan="2">204,527</td>
<td>172</td>
<td>128</td>
<td>37</td>
<td>354</td>
</tr>
<tr class="even">
<td>1994</td>
<td>15,640,150</td>
<td>4.95%</td>
<td>16,656,477</td>
<td>2,793,920</td>
<td>1,066,534</td>
<td>25,442,000</td>
<td>26,508,534</td>
<td colspan="2">203,884</td>
<td>172</td>
<td>128</td>
<td>37</td>
<td>366</td>
</tr>
<tr class="odd">
<td>1995</td>
<td>16,214,684</td>
<td>5.00%</td>
<td>17,489,301</td>
<td>2,822,584</td>
<td>1,061,741</td>
<td>25,900,000</td>
<td>26,961,741</td>
<td colspan="2">200,987</td>
<td>173</td>
<td>133</td>
<td>39</td>
<td>376</td>
</tr>
<tr class="even">
<td>Change</td>
<td></td>
<td></td>
<td></td>
<td><u>4/</u></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>'80 to '95</td>
<td>$10,382,645</td>
<td></td>
<td>$11,657,262</td>
<td>132,390</td>
<td>(97,287)</td>
<td>7,696,000</td>
<td>7,598,713</td>
<td colspan="2">15,289</td>
<td>1</td>
<td>41</td>
<td>23</td>
<td>149</td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td rowspan="2"></td>
<td rowspan="2"></td>
<td rowspan="2"></td>
</tr>
<tr class="odd">
<td colspan="11">1/ This column starts with a 1980 appropriation base
and adds the annual Medical CPI percentage increase to it for each
fiscal year.</td>
</tr>
<tr class="even">
<td colspan="4">2/ Validated data prior to 1989 not available.</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td rowspan="2"></td>
<td rowspan="2"></td>
<td rowspan="2"></td>
<td rowspan="2"></td>
</tr>
<tr class="odd">
<td colspan="10">3/ This includes both acute and long term care
discharges plus those inpatients remaining in the VAMC at the end of the
fiscal year (end of year</td>
</tr>
<tr class="even">
<td colspan="6">census); Some patients are admitted more than once in
the fiscal year.</td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="9"><p>4/ The change in unique individuals is for 1989 to
1995.</p>
<p>5/ The numbers in this column are derived from prior year budget
documents. Please see footnote 2, page 12.</p></td>
<td colspan="5"></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="14">The Medical Care appropriation for the years 1981 to
1995 is short $10.5 billion from an appropriation for this period
adjusted by the Bureau of Labor Statistics</td>
</tr>
<tr class="even">
<td colspan="13">Medical Consumer Price Index (MCPI). In 1995 alone, the
shortfall is $1.27 billion. Also, since 1980 there have been significant
VA program expansions.</td>
<td rowspan="4"></td>
</tr>
<tr class="odd">
<td colspan="13">That is, new programs have been added or expanded such
as PTSD, Persian Gulf services, Ionizing radiation, Agent Orange and
other health services that are</td>
</tr>
<tr class="even">
<td colspan="13">unique to veterans. In addition, new installations have
been constructed and activated including hospitals, nursing homes,
domiciliaries and outpatient clinics.</td>
</tr>
<tr class="odd">
<td colspan="13">The chart provides some indicators of program growth as
measured by increases in the number of individual veterans receiving VA
health care, staffing, and</td>
</tr>
<tr class="even">
<td colspan="7">episodes of care (outpatient and in total reflecting a
shift from inpatient to ambulatory care).</td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>