Session number: 1135
Abstract title: Patients’ Experiences with Health Care in the Veterans Health Administration
Author(s):
XS Ren - Center for Health Quality, Outcomes, and Economic Research
Bedford VAMC 152
LE Kazis - Center for Health Quality, Outcomes, and Economic Research
Bedford VAMC 152
A Lee - Center for Health Quality, Outcomes, and Economic Research
Bedford VAMC 152
S Sukpraprut - Boston University School of Public Health
Objectives: Information about patients’ satisfaction with care has been routinely collected and used for quality improvement within the VHA. However, little is known regarding the satisfaction with health care among the broader VA enrollee population. In this presentation, we compare the ratings of healthcare among enrollees across 22 VISNs and among enrollees who have a regular doctor in the VA vs. those who have a regular doctor outside the VA.
Methods: The study was based on the 1999 Large Health Survey, a national probability sample of VA enrollees. The study focused on the 20% sub-sample who were randomly assigned to the Patients’ Experiences with Health Care Module (N = 168,878, representing a response rate of 63.6%). We used ordinary least squares regression with general linear model procedures, adjusting for age and overall general health.
Results: VHA did relatively well in the ratings of overall quality of care, but relatively poorly in other domains of education/information, emotional support, and coordination of care. Across VISNs, there are relatively small variations in most domains of care. However, notable variations across VISNs were observed in the domain of Access to Care. Also, compared to enrollees with non-VA regular doctors, those with VA regular doctors reported most problems in access to care.
Conclusions: Despite the attention VHA has given to continuity of health care services for veterans, 20% of overall VA enrollees reported that they did not have one person they thought of as their regular doctor. In comparing enrollees who had a VA and those with non-VA regular doctor, areas suggesting a need for improvement are in access to care. Particular efforts should be made to reduce the travelling time to VA regular doctor’s office and to identify the barriers to coordination of care, education/information, and emotional support so as to improve these aspects of patient care.
Impact statement: The findings of the study highlight the need for VHA to address problems related to assigning a regular doctor to VA enrollees and to exert more attention to improving access to care and coordination of care.