Abstract
The purpose of this study was to develop an in-depth understanding of the barriers and enablers of effective dual care (care
obtained from the Veterans Health Administration [VHA] and the private health system) for rural veterans. Telephone interviews
of a random sample of 1,006 veterans residing in rural Nebraska were completed in 2010. A high proportion of the rural veterans
interviewed reported receiving dual care. The common reasons cited for seeking care outside the VHA (or VA [Veterans Administration])
included having an established relationship with a non-VA provider and distance to the nearest VA medical center. Almost half
of the veterans who reported having a personal doctor or nurse reported that this was a non-VA provider. Veterans reported
high levels of satisfaction with the quality of care they receive. Ordinal logistic regression models found that veterans
who were Medicare beneficiaries, and who rated their health status higher had higher satisfaction with dual care. The reasons
cited by the veterans for seeking care at the VHA (quality of VHA care, lower costs of VHA care, entitlement) and veterans
perceptions about dual care (confused about where to seek care for different ailments, perceived lack of coordination between
VA and non VA providers) were significant predictors of veterans’ satisfaction with dual care. This study will guide policymakers
in the VA to design a shared care system that can provide seamless, timely, high quality and veteran centered care.
obtained from the Veterans Health Administration [VHA] and the private health system) for rural veterans. Telephone interviews
of a random sample of 1,006 veterans residing in rural Nebraska were completed in 2010. A high proportion of the rural veterans
interviewed reported receiving dual care. The common reasons cited for seeking care outside the VHA (or VA [Veterans Administration])
included having an established relationship with a non-VA provider and distance to the nearest VA medical center. Almost half
of the veterans who reported having a personal doctor or nurse reported that this was a non-VA provider. Veterans reported
high levels of satisfaction with the quality of care they receive. Ordinal logistic regression models found that veterans
who were Medicare beneficiaries, and who rated their health status higher had higher satisfaction with dual care. The reasons
cited by the veterans for seeking care at the VHA (quality of VHA care, lower costs of VHA care, entitlement) and veterans
perceptions about dual care (confused about where to seek care for different ailments, perceived lack of coordination between
VA and non VA providers) were significant predictors of veterans’ satisfaction with dual care. This study will guide policymakers
in the VA to design a shared care system that can provide seamless, timely, high quality and veteran centered care.
- Content Type Journal Article
- Category Original Paper
- Pages 1-8
- DOI 10.1007/s10900-012-9583-7
- Authors
- Preethy Nayar, Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4350, USA
- Bettye Apenteng, Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4350, USA
- Fang Yu, Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4350, USA
- Peter Woodbridge, Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4350, USA
- Ann Fetrick, Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4350, USA
- Journal Journal of Community Health
- Online ISSN 1573-3610
- Print ISSN 0094-5145