Polly H Noël1,2, Jenny M Barnard3, Frances M Barry3,4, Alissa Simon3, Martin L Lee3,5, Tanya T Olmos-Ochoa3, Neetu Chawla3,5, Danielle E Rose3, Susan E Stockdale3,6, Erin P Finley1,7, Lauren S Penney1,7, David A Ganz3,4. 1. Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, South Texas Veterans Health Care System, San Antonio, Texas. 2. Department of Family and Community Medicine, University of Texas Health San Antonio, San Antonio, Texas. 3. HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Sepulveda, California. 4. David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California. 5. Fielding School of Public Health, University of California at Los Angeles, Los Angeles, California. 6. Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California. 7. Department of Medicine, University of Texas Health San Antonio, San Antonio, Texas.
Abstract
OBJECTIVE: To compare health care system problems or "hassles" experienced by Veterans receiving VA health care only versus those receiving dual care from both VA and non-VA community providers. DATA SOURCES: We collected survey data in 2017-2018 from 2444 randomly selected Veterans with four or more primary care visits in the prior year at one of 12 VA primary care clinics located in four geographically diverse regions of the United States. STUDY DESIGN: We used baseline surveys from the Coordination Toolkit and Coaching quality improvement project to explore Veterans' experience of hassles (dependent variable), source of health care, self-rated physical and mental health, and sociodemographics. DATA COLLECTION: Participants responded to mailed surveys by mail, telephone, or online. PRINCIPAL FINDINGS: The number of reported hassles ranged from 0 to 16; 79 percent of Veterans reported experiencing one or more hassles. Controlling for sociodemographic characteristics and self-rated physical and mental health, zero-inflated negative binominal regression indicated that dual care users experienced more hassles than VA-only users (adjusted predicted average 5.5 [CI: 5.2, 5.8] vs 4.3 [CI: 4.1, 4.6] hassles [P < .0001]). CONCLUSIONS: Anticipated increases in Veterans accessing community-based care may require new strategies to help VA primary care teams optimize care coordination for dual care users. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.
OBJECTIVE: To compare health care system problems or "hassles" experienced by Veterans receiving VA health care only versus those receiving dual care from both VA and non-VA community providers. DATA SOURCES: We collected survey data in 2017-2018 from 2444 randomly selected Veterans with four or more primary care visits in the prior year at one of 12 VA primary care clinics located in four geographically diverse regions of the United States. STUDY DESIGN: We used baseline surveys from the Coordination Toolkit and Coaching quality improvement project to explore Veterans' experience of hassles (dependent variable), source of health care, self-rated physical and mental health, and sociodemographics. DATA COLLECTION: Participants responded to mailed surveys by mail, telephone, or online. PRINCIPAL FINDINGS: The number of reported hassles ranged from 0 to 16; 79 percent of Veterans reported experiencing one or more hassles. Controlling for sociodemographic characteristics and self-rated physical and mental health, zero-inflated negative binominal regression indicated that dual care users experienced more hassles than VA-only users (adjusted predicted average 5.5 [CI: 5.2, 5.8] vs 4.3 [CI: 4.1, 4.6] hassles [P < .0001]). CONCLUSIONS: Anticipated increases in Veterans accessing community-based care may require new strategies to help VA primary care teams optimize care coordination for dual care users. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.
Entities:
Keywords:
Veteran; baseline survey; care coordination; patient experience; primary care
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