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Hospitals offer medical and surgical care to the sick and injured, along with accommodation while they recover. At the same time, they also provide outpatient, emergency, psychiatric, and rehabilitation services to meet various community needs. In addition to providing medical care, hospitals also act as hubs for medical research and training. Hospitals use clinical procedures and evidence-based practice standards to deliver patient care. To deliver safe and efficient care, a nurse must stay up...
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Hospitals provide inpatient and outpatient services. Inpatient services provide care to patients that stay in the hospital for an extended period, ranging from days to months. Examples of inpatient services include intensive care units, hospital wards, or surgeries. Outpatient services provide care to patients who come to a hospital for a diagnostic or treatment but do not stay overnight —for example, diagnostic tests, surgical procedures, or health education.
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Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
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Hospital and Patient Factors Affecting Veterans' Hospital Choice.

Jean Yoon1,2, Michael K Ong3,4,5, Megan E Vanneman6,7

  • 1VA Palo Alto Health Care System, Menlo Park, CA, USA.

Medical Care Research and Review : MCRR
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Veterans increasingly chose non-VA care after 2014. Factors like academic affiliation and patient experience influenced hospital choice, with specific patient groups preferring VA hospitals.

Keywords:
Veteranacademichospitalpatient experience

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Area of Science:

  • Health Services Research
  • Health Economics
  • Health Policy

Background:

  • The Veterans Affairs (VA) healthcare system expanded access to non-VA care for enrolled veterans starting in 2014.
  • Understanding factors influencing patient choice between VA and non-VA healthcare facilities is crucial for system planning and resource allocation.

Purpose of the Study:

  • To examine the characteristics of hospitals and veterans associated with the choice of healthcare facility.
  • To model veteran preferences for VA hospitals versus large and small non-VA hospitals.

Main Methods:

  • A longitudinal study design was employed, analyzing elective hospitalizations between 2011 and 2017 across 11 states.
  • Conditional logit models were used to analyze patient choices among VA hospitals, large non-VA hospitals, and small non-VA hospitals.

Main Results:

  • Patients were more likely to select hospitals with academic affiliations, higher patient experience ratings, closer proximity, and common hospital types.
  • Male veterans, racial/ethnic minorities, those with higher VA enrollment priority, and individuals with mental health comorbidities showed a greater propensity to choose VA hospitals over non-VA options.

Conclusions:

  • Veteran hospital choice is significantly influenced by specific hospital attributes, including quality and patient experience.
  • To remain competitive and retain patients, VA hospitals must focus on maintaining or enhancing their quality of care and patient experience.