VA Outreach Is an Essential Area for Improving Veterans' Health Care Accessibility.

Autor: Stryczek KC; VA Northeast Ohio Healthcare System, Research & Development, Cleveland, OH 44106, USA., Honsberger M; VA Northeast Ohio Healthcare System, Research & Development, Cleveland, OH 44106, USA., Ball SL; VA Northeast Ohio Healthcare System, Research & Development, Cleveland, OH 44106, USA., Barnard JG; VA Eastern Colorado Health Care System, Center of Innovation for Veteran-Centered and Value-Driven Care, Aurora, CO 80045, USA.; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA., Young JP; VA Puget Sound Health Care System, Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA 98108, USA., Felker B; VA Puget Sound Health Care System, Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA 98108, USA.; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA., Au DH; VA Puget Sound Health Care System, Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA 98108, USA.; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195-6522, USA., Ho PM; VA Eastern Colorado Health Care System, Center of Innovation for Veteran-Centered and Value-Driven Care, Aurora, CO 80045, USA.; Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA., Kirsh SR; The U.S. Department of Veterans Affairs Central Office, Washington, DC 20420, USA., Sayre GG; VA Puget Sound Health Care System, Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA 98108, USA.; Department of Health Services, University of Washington School of Public Health, Seattle, WA 98195, USA.
Jazyk: angličtina
Zdroj: Military medicine [Mil Med] 2023 Jul 22; Vol. 188 (7-8), pp. e2439-e2447.
DOI: 10.1093/milmed/usad019
Abstrakt: Introduction: The Veterans Health Administration (VHA) is tasked with providing access to health care to veterans of military service. However, many eligible veterans have either not yet enrolled or underutilized VHA services. Further study of barriers to access before veterans enroll in VHA care is necessary to understand how to address this issue. The ChooseVA (née MyVA Access) initiative aims to achieve this mission to improve veterans' health care access. Although veteran outreach was not specifically addressed by the initiative, it is a critical component of improving veterans' access to health care. Findings from this multisite evaluation of ChooseVA implementation describe sites' efforts to improve VHA outreach and veterans' experiences with access.
Materials and Methods: This quality improvement evaluation employed a multi-method qualitative methodology, including 127 semi-structured interviews and 81 focus groups with VHA providers and staff ("VHA staff") completed during 21 VHA medical center facility site visits between July and November 2017 and 48 telephone interviews with veterans completed between May and October 2018. Interviews and focus groups were transcribed and analyzed using deductive and inductive analysis to capture challenges and strategies to improve VHA health care access (VHA staff data), experiences with access to care (veteran data), barriers and facilitators to care (staff and veteran data), contextual factors, and emerging categories and themes. We developed focused themes describing perceived challenges, descriptions of VHA staff efforts to improve veteran outreach, and veterans' experiences with accessing VHA health care.
Results: VHA staff and veteran respondents reported a lack of veteran awareness of eligibility for VHA services. Veterans reported limited understanding of the range of services offered. This awareness gap served as a barrier to veterans' ability to successfully access VHA health care services. Veterans described this awareness gap as contributing to delayed VHA enrollment and delayed or underutilized health care benefits and services. Staff focused on community outreach and engaging veterans for VHA enrollment as part of their efforts to implement the ChooseVA access initiative. Staff and veteran respondents agreed that outreach efforts were helpful for engaging veterans and facilitating access.
Conclusions: Although efforts across VHA programs informed veterans about VHA services, our results suggest that both VHA staff and veterans agreed that missed opportunities exist. Gaps include veterans' lack of awareness or understanding of VHA benefits for which they qualify for. This can result in delayed access to care which may negatively impact veterans, including those separating from the military and vulnerable populations such as veterans who experience pregnancy or homelessness.
(Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.)
Databáze: MEDLINE
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