Improving care for rural veterans: are high dual users different?

Area of Science:

• Health Services Research
• Rural Health
• Veterans Affairs

Background:

• Rural veterans encounter significant barriers accessing healthcare.
• Many rural veterans utilize healthcare services outside the Veterans Health Administration (VHA), known as dual care.

Purpose of the Study:

• To identify characteristics of high-frequency dual care users versus occasional/non-users.
• To determine factors influencing satisfaction with care among rural veterans.

Main Methods:

• Cross-sectional observational study design.
• Structured telephone interviews with a random sample of rural Nebraska veterans in 2011.
• Multinomial and ordinal regression models to assess dual care use and satisfaction.

Main Results:

• Strong VHA relationships and satisfaction with VHA care reduced high dual care use.
• Medicare, private insurance, chronic illnesses, and confusion about care seeking increased dual care use.
• Confusion about seeking care and perceived lack of VHA-non-VHA coordination correlated with lower satisfaction.

Conclusions:

• Understanding dual care motivations and satisfaction drivers is crucial for the VHA.
• Policy implementation can improve the quality of care for rural veterans.