Evidence map›Paper›PMID 36922468›Full record

ArticleJournal of general internal medicine2023

VA-Delivered or VA-Purchased Care: Important Factors for Veterans Navigating Care Decisions.

Megan Lafferty, Diana J Govier, Sara E Golden, Natalie G Disher, Denise M Hynes, Christopher G Slatore

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Megan LaffertyCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA. megan.lafferty@va.gov.ORCID 0000-0002-8021-3211
Diana J GovierCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA.
Sara E GoldenCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA.
Natalie G DisherCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA.
Denise M HynesCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA.
Christopher G SlatoreCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA.

Funding

Care Coordination and Outcomes for High Risk Patients: Building the Evidence for ImplementationI01HX003261 · VA · PORTLAND VA MEDICAL CENTER · PI Denise M. Hynes · 2021 to 2026
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HSR&D Senior Research Career Scientist AwardIK6HX003395 · VA · PORTLAND VA MEDICAL CENTER · PI Denise M. Hynes · 2021 to 2026
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HSRD VA I01 HX002655HSRD VA I01 HX003261HSRD VA IK6 HX003395
6 · The paper itself

Abstract

BACKGROUND/

objectiveThe VA MISSION Act aimed to increase Veterans' access to care by allowing eligible Veterans to use VA-paid care from non-VA providers ("VA-purchased care"). We interviewed Veterans who were eligible for both VA-delivered and VA-purchased care to examine factors they consider when making decisions about whether to use VA-delivered or VA-purchased care.

methodsWe conducted semi-structured interviews with 28 Veterans across the USA who were eligible for VA-delivered and VA-purchased care, using deductive and inductive analysis to develop themes. Participants were recruited from a survey about healthcare access and decision-making. More than half of participants lived in rural areas, 21 were men, and 25 were > 50 years old. KEY

resultsVeteran participants identified (1) high-quality relationships with providers based on mutual trust, empathy, authenticity, and continuity of care, and (2) a positive environment or "eco-system of care" characterized by supportive interactions with staff and other Veterans, and exemplary customer service as integral to their decisions about where to receive care. These preferences influenced their engagement with VA and non-VA providers. We discovered corresponding findings related to Veterans' information needs. When making decisions around where to receive care, participants said they would like more information about VA and non-VA providers and services, and about coordination of care and referrals, including understanding processes and implications of utilizing VA-purchased care. DISCUSSION/

conclusionCurrent VA-purchased care eligibility determinations focus on common access metrics (e.g., wait times, distance to care). Yet, Veterans discussed other important factors for navigating care decisions, including patient-provider relationship quality and the larger healthcare environment (e.g., interactions with staff and other Veterans). Our findings point to the need for health systems to collect and provide information on these aspects of care to ensure care decisions reflect what is important to Veterans when navigating where to receive care.

Indexed as

VeteransFemaleHealth Services AccessibilityHumansMaleMiddle AgedProfessional-Patient RelationsQualitative ResearchUnited StatesUnited States Department of Veterans Affairsaccess to carecontinuity of carepatient-centered carequalitative researchquality of care

Identifiers

PMID36922468
PMCPMC10212855

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.