The role of constituency groups in policy formulation: items for a health services research agenda.

The Veterans Administration medical care system functions within a larger VA services program that has as its direct constituency many organized veterans' groups. The VA system is viewed from the larger perspective of consumer representation in its direction through three effective functions of consumer representation: ownership, control, and oversight. In the VA the Congress and the veterans' groups perform these functions with varying levels of impact on the system. While veterans feel a measure of ownership of the medical care system, they have little voice in its actual operation. Research is needed to describe more fully fully the actual role of the veterans-client in the system and to explore the possibility that aspects of the system may be adopted outside.