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National Veteran Health Equity Report 2021 Condensed Report. Focus on Veterans Health Administration Patient Experience and Health Care Quality

Washington DL, Yuan A, Toyama JA, Jackson LB, Kasom DR, Canning MT, Steers WN. National Veteran Health Equity Report 2021 Condensed Report. Focus on Veterans Health Administration Patient Experience and Health Care Quality. Washington, DC: Office of Health Equity Veterans Health Administration; 2022 Sep 1. 232 p.




Abstract:

Background This National Veteran Health Equity Report 2021 provides information regarding disparities in patient experiences and health care quality for Veterans who obtain health care services through the Veterans Health Administration (VHA). Data on disparities are presented by the sociodemographic characteristics of race/ethnicity, gender, age group, rurality of residence, socio-economic status, and service-connected disability rating, and by cardiovascular risk factors of hypertension, hyperlipidemia, and diabetes. Data in this report are from the fiscal year 2016 to fiscal year 2019 Department of Veteran Affairs (VA) Survey of Healthcare Experiences of Patients (SHEP) Patient Centered Medical Home survey instrument, and the fiscal year 2016 to fiscal year 2019 VA External Peer Review Program quality monitoring program. Key Findings on Comparisons in Patient Experiences Patient experiences of VHA Care were compared for three domains of patient experience: - Access - getting timely appointments, care, and information - Person-centered care o Communication - how well providers communicate with patients and how helpful and respectful office staff are o Comprehensiveness - providers paying attention to patient's mental or emotional health o Self-management support - providers supporting patients in taking care of their own health - Care Coordination - provider's use of information to coordinate patient care, including discussing medication decisions Key findings: - For most groups experiencing disparities in patient experience, there were more frequent gaps in person-centered care and less frequent gaps in access to care and care coordination. - On average, the greatest gaps in patient experience were for Veterans under age 45 years of age when compared to those age 65 and older. - In contrast to non-Hispanic White Veterans, disparities in access to care were most often reported by Black, Asian, more than one race, and Hispanic Veteran groups. - In contrast to non-Hispanic White Veterans, disparities in person-centered care were most often reported by American Indian or Alaska Native, Asian, and more than one race Veteran groups. National Veteran Health Equity Report 2021 2 - Female Veterans of reproductive age (18-44 years) experienced widespread disparities in person-centered care compared to Male Veterans of the same age group - Veteran VHA users with low socio-economic status (SES) experienced a wide range of disparities in person-centered care compared with their higher SES counterparts. - There were no patient experience disparities by rurality of residence. Key Findings on Comparisons in Health Care Quality Quality of VHA Care was compared for three domains of quality: - Effective Treatment o Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease - Healthy Living - Lifestyle Modification o Promoting lifestyle changes to address behavioral risk factors for chronic conditions - Healthy Living - Clinical Preventive Services o Promoting wide use of best practices to enable healthy living Key findings: - The most frequent disparities in quality of care were for healthy living - clinical preventive services. - By race/ethnicity, Black and American Indian or Alaska Native Veteran groups had the greatest disparities compared with non-Hispanic White Veterans, with worse care quality on 40% or more measures in at least one domain of care quality. - Women Veterans age 65 and older had large gaps in quality compared with male Veterans in that age group, whereas gender differences were less apparent for younger age groups. - Quality gaps were present for Veterans with low socio-economic status in healthy living-clinical preventive services, and in healthy living-lifestyle modification - Across domains, quality gaps were present for Veterans under age 65 in comparison to those age 65 and older.





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