Cargando…

Choosing Veterans Affairs: Determinants of post-9/11 Veterans’ enrollment in Veterans Affairs health care

Following recent policy changes, younger Veterans have particularly increased options for where to receive their health care. Although existing research provides some understanding of non-modifiable individual (e.g., age) and external community (e.g., non-VA provider supply) factors that influence V...

Descripción completa

Detalles Bibliográficos
Autores principales: Vanneman, Megan E., Samore, Matthew H., Zheng, Tianyu, Pettey, Warren B.P., Fagerlin, Angela, Harris, Alex H.S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10443737/
https://www.ncbi.nlm.nih.gov/pubmed/37603531
http://dx.doi.org/10.1097/MD.0000000000034814
_version_ 1785093899771969536
author Vanneman, Megan E.
Samore, Matthew H.
Zheng, Tianyu
Pettey, Warren B.P.
Fagerlin, Angela
Harris, Alex H.S.
author_facet Vanneman, Megan E.
Samore, Matthew H.
Zheng, Tianyu
Pettey, Warren B.P.
Fagerlin, Angela
Harris, Alex H.S.
author_sort Vanneman, Megan E.
collection PubMed
description Following recent policy changes, younger Veterans have particularly increased options for where to receive their health care. Although existing research provides some understanding of non-modifiable individual (e.g., age) and external community (e.g., non-VA provider supply) factors that influence VA enrollment, this study focused on modifiable facility access and quality factors that could influence Veterans’ decisions to enroll in VA. In this cohort study, we examined enrollment in and use of VA services in the year following military separation as the binary outcome using mixed-effects logistic regressions, stratified by Active and Reserve Components. This study included 260,777 Active and 101,572 Reserve Component post-9/11 Veterans separated from the military in fiscal years 2016 to 2017. Independent variables included 4 access measures for timeliness of VA care and 3 VA quality measures, which are included in VA Medical Centers’ performance plans. Eligible Veterans were more likely to enroll in VA when the closest VA had higher quality scores. After accounting for timeliness of VA care and non-modifiable characteristics, rating of primary care (PC) providers was associated with higher VA enrollment for Active Component (odds ratio [OR] = 1.014, 95% confidence interval [CI]: 1.007–1.020). Higher mental health (MH) continuity (OR = 1.039, 95% CI: 1.000–1.078) and rating of PC providers (OR = 1.009, 95% CI: 1.000–1.017) were associated with higher VA enrollment for Reserve Component. Improving facility-specific quality of care may be a way to increase VA enrollment. In a changing policy environment, study results will help VA leadership target changes they can make to manage enrollment of Veterans in VA and deliver needed foundational services.
format Online
Article
Text
id pubmed-10443737
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-104437372023-08-23 Choosing Veterans Affairs: Determinants of post-9/11 Veterans’ enrollment in Veterans Affairs health care Vanneman, Megan E. Samore, Matthew H. Zheng, Tianyu Pettey, Warren B.P. Fagerlin, Angela Harris, Alex H.S. Medicine (Baltimore) 5400 Following recent policy changes, younger Veterans have particularly increased options for where to receive their health care. Although existing research provides some understanding of non-modifiable individual (e.g., age) and external community (e.g., non-VA provider supply) factors that influence VA enrollment, this study focused on modifiable facility access and quality factors that could influence Veterans’ decisions to enroll in VA. In this cohort study, we examined enrollment in and use of VA services in the year following military separation as the binary outcome using mixed-effects logistic regressions, stratified by Active and Reserve Components. This study included 260,777 Active and 101,572 Reserve Component post-9/11 Veterans separated from the military in fiscal years 2016 to 2017. Independent variables included 4 access measures for timeliness of VA care and 3 VA quality measures, which are included in VA Medical Centers’ performance plans. Eligible Veterans were more likely to enroll in VA when the closest VA had higher quality scores. After accounting for timeliness of VA care and non-modifiable characteristics, rating of primary care (PC) providers was associated with higher VA enrollment for Active Component (odds ratio [OR] = 1.014, 95% confidence interval [CI]: 1.007–1.020). Higher mental health (MH) continuity (OR = 1.039, 95% CI: 1.000–1.078) and rating of PC providers (OR = 1.009, 95% CI: 1.000–1.017) were associated with higher VA enrollment for Reserve Component. Improving facility-specific quality of care may be a way to increase VA enrollment. In a changing policy environment, study results will help VA leadership target changes they can make to manage enrollment of Veterans in VA and deliver needed foundational services. Lippincott Williams & Wilkins 2023-08-18 /pmc/articles/PMC10443737/ /pubmed/37603531 http://dx.doi.org/10.1097/MD.0000000000034814 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
spellingShingle 5400
Vanneman, Megan E.
Samore, Matthew H.
Zheng, Tianyu
Pettey, Warren B.P.
Fagerlin, Angela
Harris, Alex H.S.
Choosing Veterans Affairs: Determinants of post-9/11 Veterans’ enrollment in Veterans Affairs health care
title Choosing Veterans Affairs: Determinants of post-9/11 Veterans’ enrollment in Veterans Affairs health care
title_full Choosing Veterans Affairs: Determinants of post-9/11 Veterans’ enrollment in Veterans Affairs health care
title_fullStr Choosing Veterans Affairs: Determinants of post-9/11 Veterans’ enrollment in Veterans Affairs health care
title_full_unstemmed Choosing Veterans Affairs: Determinants of post-9/11 Veterans’ enrollment in Veterans Affairs health care
title_short Choosing Veterans Affairs: Determinants of post-9/11 Veterans’ enrollment in Veterans Affairs health care
title_sort choosing veterans affairs: determinants of post-9/11 veterans’ enrollment in veterans affairs health care
topic 5400
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10443737/
https://www.ncbi.nlm.nih.gov/pubmed/37603531
http://dx.doi.org/10.1097/MD.0000000000034814
work_keys_str_mv AT vannemanmegane choosingveteransaffairsdeterminantsofpost911veteransenrollmentinveteransaffairshealthcare
AT samorematthewh choosingveteransaffairsdeterminantsofpost911veteransenrollmentinveteransaffairshealthcare
AT zhengtianyu choosingveteransaffairsdeterminantsofpost911veteransenrollmentinveteransaffairshealthcare
AT petteywarrenbp choosingveteransaffairsdeterminantsofpost911veteransenrollmentinveteransaffairshealthcare
AT fagerlinangela choosingveteransaffairsdeterminantsofpost911veteransenrollmentinveteransaffairshealthcare
AT harrisalexhs choosingveteransaffairsdeterminantsofpost911veteransenrollmentinveteransaffairshealthcare