Dual use of VA and non-VA primary care.
J Gen Intern Med
; 14(5): 274-80, 1999 May.
Article
en En
| MEDLINE
| ID: mdl-10337036
ABSTRACT
OBJECTIVE:
To determine how frequently veterans use non-Department of Veterans Affairs (VA) sources of care in addition to primary care provided by the VA and to assess the association of this pattern of "dual use" to patient characteristics and satisfaction with VA care.DESIGN:
Cross-sectional telephone survey of randomly selected patients from four VA medical centers.PARTICIPANTS:
Of 1,240 eligible veterans, 830 (67%) participated in the survey. MEASUREMENTS AND MAINRESULTS:
Survey data were used to assess whether a veteran reported receiving primary care from both VA and non-VA sources of care, as well as the proportion of all primary care visits made to non-VA providers. Of 577 veterans who reported VA primary care visits, 159 (28%) also reported non-VA primary care visits. Among these dual users the mean proportion of non-VA primary care visits was 0.50. Multivariate analysis revealed that the odds of dual use were reduced for those without insurance (odds ratio [OR] 0.34; 95% confidence interval [CI] 0.18, 0.66) and with less education (OR 0.60; 95% CI 0.38, 0.92), while increased for those not satisfied with VA care (OR 2.40; 95% CI 1.40, 4.13). Among primary care dual users, the proportion of primary care visits made to non-VA providers was decreased for patients with heart disease ( p <.05) and patients with alcohol or drug dependence ( p <.05).CONCLUSIONS:
Primary care dual use was common among these veterans. Those with more education, those with any type of insurance, and those not satisfied with VA care were more likely to be dual users. Non-VA care accounted for approximately half of dual users' total primary care visits.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Atención Primaria de Salud
/
Veteranos
/
Hospitales Privados
/
Hospitales de Veteranos
Tipo de estudio:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
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Risk_factors_studies
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Gen Intern Med
Asunto de la revista:
MEDICINA INTERNA
Año:
1999
Tipo del documento:
Article