Experiences With VA-Purchased Community Care for US Veterans With Mental Health Conditions

Area of Science:

• Health Services Research
• Mental Health Services
• Veterans Affairs Healthcare

Background:

• Veterans with mental health conditions (MHC) face unique challenges accessing coordinated healthcare.
• Community care (CC) is increasingly utilized for veterans outside the Veterans Health Administration (VA).
• Evidence is needed on the experiences of veterans with MHC receiving CC.

Purpose of the Study:

• To compare the healthcare experiences of US veterans with and without MHC receiving CC over time.
• To identify specific domains where experiences differ between these groups.

Main Methods:

• Retrospective, cross-sectional survey study analyzing data from the Survey of Healthcare Experiences of Patients-Community Care Survey (SHEP-CCS) from 2016 to 2021.
• Compared ratings across 9 domains for veterans with and without MHC using regression models.
• Included over 231,000 veterans, with 27.1% diagnosed with MHC.

Main Results:

• Veterans with MHC reported significantly lower overall satisfaction with CC (-1.8 points, P < .001).
• Ratings across all 9 domains were consistently lower for veterans with MHC compared to those without MHC.
• Despite overall improvements in CC ratings from 2016-2021, significant disparities between groups persisted.

Conclusions:

• Veterans with MHC consistently reported poorer experiences with community care across all measured domains.
• These persistent differences highlight the need for focused care coordination and quality improvement initiatives.
• Targeted efforts are crucial to enhance the CC experience for this vulnerable veteran subpopulation.