Racial Differences in Satisfaction with VA Health Care: A Mixed Methods Pilot Study

Area of Science:

• Health Services Research
• Health Disparities
• Patient Satisfaction

Background:

• Patient satisfaction is linked to adherence and active participation in care.
• Understanding factors influencing patient satisfaction is critical for healthcare improvement.
• Racial disparities in healthcare satisfaction were identified within the Veterans Affairs (VA) system.

Purpose of the Study:

• To investigate underlying reasons for lower healthcare satisfaction among African American veterans compared to White veterans.
• To gather preliminary qualitative and quantitative data on racial differences in patient satisfaction within the VA.
• To address findings from a VA Hospital Report Card highlighting racial disparities.

Main Methods:

• A mixed-methods pilot study involving 30 African American and 31 White veterans.
• Telephone interviews were conducted with veterans having recent inpatient and/or outpatient VA healthcare experiences.
• Qualitative interviews were coded for themes; quantitative analysis used logistic regression to compare racial groups.

Main Results:

• African Americans were younger and more educated than White veterans.
• Qualitative findings indicated lower African American satisfaction with provider trust and communication.
• Quantitatively, African Americans reported less satisfaction with outpatient care and the domain of trust/confidence.

Conclusions:

• The pilot study confirmed racial differences in satisfaction with VA outpatient care.
• Specific sources of dissatisfaction, including trust and communication, were identified.
• Future research will expand to a national cohort, including Hispanic veterans, to further explore racial/ethnic disparities.