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Related Experiment Videos

VA community-based outpatient clinics: access and utilization performance measures.

John C Fortney1, Steven J Borowsky, Ashley N Hedeen

  • 1Health Services Research and Development, Center for Mental Health and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas 72114-1706, USA. FortneyJohnC@uams.edu

Medical Care
|July 27, 2002
PubMed
Summary

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Community-Based Outpatient Clinics (CBOCs) attract new patients and increase primary care use within the VA healthcare system. VA-staffed CBOCs show higher primary care utilization than contract CBOCs.

Area of Science:

  • Health Services Research
  • Healthcare Management
  • Public Health

Background:

  • Community-Based Outpatient Clinics (CBOCs) are integral to the Veterans Affairs (VA) healthcare system.
  • Understanding their performance relative to parent VA Medical Centers (VAMCs) is crucial for optimizing patient access and care delivery.

Purpose of the Study:

  • To compare access and utilization performance between CBOCs and VAMC primary care clinics.
  • To differentiate performance between VA-staffed and contract CBOCs.

Main Methods:

  • Cross-sectional, retrospective study design.
  • Analysis of administrative and research data for 37,084 CBOC patients and 318,369 VAMC primary care patients.
  • Six months of service use data analyzed using multivariate regression to control for casemix.

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Main Results:

  • CBOCs attract new, high-priority patients to the VA system.
  • CBOC patients utilized more primary care and fewer specialty care encounters compared to VAMC patients.
  • VA-staffed CBOC patients had higher primary care utilization than contract CBOC patients.

Conclusions:

  • CBOCs effectively attract new patients to the VA.
  • CBOCs facilitate a shift in care focus from specialty to primary care settings.
  • VA-staffed CBOCs demonstrate superior primary care utilization compared to contract CBOCs.