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Accessing Care Through the Veterans Choice Program: The Veteran Experience.
J Gen Intern Med. 2018 10; 33(10):1714-1720.JG

Abstract

BACKGROUND

The Veterans Choice Program (VCP) was implemented to improve healthcare access by expanding healthcare options for Veterans Health Administration (VHA) enrollees.

OBJECTIVES

To understand Veterans' experience accessing VCP care.

DESIGN

Qualitative content analysis.

SUBJECTS

Forty-seven veterans from three medical centers in three of the five VA geographical regions.

APPROACH

We used semi-structured telephone interviews designed to elicit descriptions of Veterans' experiences. Data was analyzed using iterative, inductive, and deductive content analysis. Broad themes were identified based on representative interview responses.

KEY RESULTS

We identified six themes: general impressions (concept and frustration); preferred source of care (institution, specialty, and individual provider); facilitators (VA staff facilitation and proactive Veterans); barriers (complexity, lack of responsiveness, lack of local providers, and poor coordination); perceived sources of VCP problems (learning curve, leadership and staff, and politics); and unintended negative impact (responsibility for costs of care and discontinued access to community care).

DISCUSSION

Most Veterans who had received care through the VCP felt that it improved their access to care. However, accessing care through the VCP is a complex process that requires proactive Veterans and active support from the VA, third-party administrators, and availability of participating community providers. Veterans' abilities to navigate this process and the level of support provided varied widely. Even patients who did receive care through VCP found the process challenging. Greater support is needed for some Veterans to successfully access VCP care because Veterans who need care the most may be the least able to access it.

Links

PMC Free PDF

Authors+Show Affiliations

Sayre GG
VA Puget Sound Health Care System, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, USA. George.Sayre@va.gov. Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA. George.Sayre@va.gov.
Neely EL
VA Puget Sound Health Care System, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, USA.
Simons CE
VA Puget Sound Health Care System, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, USA.
Sulc CA
VA Puget Sound Health Care System, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, USA.
Au DH
VA Puget Sound Health Care System, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, USA. Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, WA, USA.
Michael Ho P
VA Eastern Colorado Health Care System, Center of Innovation for Veteran-Centered and Value-Driven Care, Denver, CO, USA. University of Colorado School of Medicine, Aurora, CO, USA.

MeSH

AgedAged, 80 and overAttitude to HealthChoice BehaviorDelivery of Health CareFemaleHealth Services AccessibilityHealth Services ResearchHospitals, VeteransHumansMaleMiddle AgedProgram EvaluationQualitative ResearchUnited StatesUnited States Department of Veterans AffairsVeteransVeterans Health

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

30039494

Citation

Sayre, George G., et al. "Accessing Care Through the Veterans Choice Program: the Veteran Experience." Journal of General Internal Medicine, vol. 33, no. 10, 2018, pp. 1714-1720.
Sayre GG, Neely EL, Simons CE, et al. Accessing Care Through the Veterans Choice Program: The Veteran Experience. J Gen Intern Med. 2018;33(10):1714-1720.
Sayre, G. G., Neely, E. L., Simons, C. E., Sulc, C. A., Au, D. H., & Michael Ho, P. (2018). Accessing Care Through the Veterans Choice Program: The Veteran Experience. Journal of General Internal Medicine, 33(10), 1714-1720. https://doi.org/10.1007/s11606-018-4574-8
Sayre GG, et al. Accessing Care Through the Veterans Choice Program: the Veteran Experience. J Gen Intern Med. 2018;33(10):1714-1720. PubMed PMID: 30039494.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Accessing Care Through the Veterans Choice Program: The Veteran Experience. AU - Sayre,George G, AU - Neely,Emily L, AU - Simons,Carol E, AU - Sulc,Christine A, AU - Au,David H, AU - Michael Ho,P, Y1 - 2018/07/23/ PY - 2017/12/07/received PY - 2018/07/02/accepted PY - 2018/06/13/revised PY - 2018/7/25/pubmed PY - 2019/11/19/medline PY - 2018/7/25/entrez KW - Veterans KW - access to care KW - care transitions KW - program evaluation KW - qualitative research SP - 1714 EP - 1720 JF - Journal of general internal medicine JO - J Gen Intern Med VL - 33 IS - 10 N2 - BACKGROUND: The Veterans Choice Program (VCP) was implemented to improve healthcare access by expanding healthcare options for Veterans Health Administration (VHA) enrollees. OBJECTIVES: To understand Veterans' experience accessing VCP care. DESIGN: Qualitative content analysis. SUBJECTS: Forty-seven veterans from three medical centers in three of the five VA geographical regions. APPROACH: We used semi-structured telephone interviews designed to elicit descriptions of Veterans' experiences. Data was analyzed using iterative, inductive, and deductive content analysis. Broad themes were identified based on representative interview responses. KEY RESULTS: We identified six themes: general impressions (concept and frustration); preferred source of care (institution, specialty, and individual provider); facilitators (VA staff facilitation and proactive Veterans); barriers (complexity, lack of responsiveness, lack of local providers, and poor coordination); perceived sources of VCP problems (learning curve, leadership and staff, and politics); and unintended negative impact (responsibility for costs of care and discontinued access to community care). DISCUSSION: Most Veterans who had received care through the VCP felt that it improved their access to care. However, accessing care through the VCP is a complex process that requires proactive Veterans and active support from the VA, third-party administrators, and availability of participating community providers. Veterans' abilities to navigate this process and the level of support provided varied widely. Even patients who did receive care through VCP found the process challenging. Greater support is needed for some Veterans to successfully access VCP care because Veterans who need care the most may be the least able to access it. SN - 1525-1497 UR - https://www.unboundmedicine.com/medline/citation/30039494/Accessing_Care_Through_the_Veterans_Choice_Program:_The_Veteran_Experience_ DB - PRIME DP - Unbound Medicine ER -