Evidence map›Paper›PMID 38822210›Full record

Observational studyJournal of general internal medicine2024

Racial and Ethnic Differences in Health Care Experiences for Veterans Receiving VA Community Care from 2016 to 2021.

Sudarshan Krishnamurthy, Yaming Li, Florentina Sileanu, Utibe R Essien, Megan E Vanneman, Maria Mor, Michael J Fine, Carolyn T Thorpe, Thomas Radomski, Katie Suda and 2 more

Abstract readObservational Study
In one paragraph

Observational study in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Observational
  2. 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

12 authors.

Sudarshan KrishnamurthyDepartment of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Yaming LiVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Florentina SileanuVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Utibe R EssienVA Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, West Los Angeles, CA, USA.
Megan E VannemanDecision Enhancement and Analytic Sciences Center, VA Informatics, VA Salt Lake City Health Care System, Salt Lake City, UT, USA.
Maria MorVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Michael J FineVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Carolyn T ThorpeVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Thomas RadomskiVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Katie SudaVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Walid F GelladVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Eric T RobertsVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA. Eric.Roberts@pennmedicine.upenn.edu.

Funding

Improving Analysis of Endogenous Multimodal Treatments for Use in Geriatrics Health Outcomes StudiesI01HX002237 · VA · VA BOSTON HEALTH CARE SYSTEM · PI GARRIDO, MELISSA M · 2018 to 2021
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Leveraging a natural experiment to identify the effects of VA community care programs on health care quality, equity, and Veteran experiencesI01HX003457 · VA · VETERANS HEALTH ADMINISTRATION · PI Walid F. Gellad, Eric T Roberts · 2022 to 2026
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Access to and Choice of VA or Non-VA Health Care by Veterans of Recent ConflictsIK2HX002625 · VA · VA SALT LAKE CITY HEALTHCARE SYSTEM · PI VANNEMAN, MEGAN ENFIELD · 2020 to 2025
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HSRD VA I01 HX003457HSRD VA IK2 HX002625HSRD VA SDR 02-237U.S. Department of Veterans Affairs 1IK2HX002625-01U.S. Department of Veterans Affairs 98-004U.S. Department of Veterans Affairs CDA 15-259U.S. Department of Veterans Affairs I01HX003457-01
6 · The paper itself

Abstract

backgroundPrior research documented racial and ethnic disparities in health care experiences within the Veterans Health Administration (VA). Little is known about such differences in VA-funded community care programs, through which a growing number of Veterans receive health care. Community care is available to Veterans when care is not available through the VA, nearby, or in a timely manner.

objectiveTo examine differences in Veterans' experiences with VA-funded community care by race and ethnicity and assess changes in these experiences from 2016 to 2021.

designObservational analyses of Veterans' ratings of community care experiences by self-reported race and ethnicity. We used linear and logistic regressions to estimate racial and ethnic differences in community care experiences, sequentially adjusting for demographic, health, insurance, and socioeconomic factors.

participantsRespondents to the 2016-2021 VA Survey of Healthcare Experiences of Patients-Community Care Survey. MEASURES: Care ratings in nine domains. KEY

resultsThe sample of 231,869 respondents included 24,306 Black Veterans (mean [SD] age 56.5 [12.9] years, 77.5% male) and 16,490 Hispanic Veterans (mean [SD] age 54.6 [15.9] years, 85.3% male). In adjusted analyses pooled across study years, Black and Hispanic Veterans reported significantly lower ratings than their White and non-Hispanic counterparts in five of nine domains (overall rating of community providers, scheduling a recent appointment, provider communication, non-appointment access, and billing), with adjusted differences ranging from - 0.04 to - 0.13 standard deviations (SDs) of domain scores. Black and Hispanic Veterans reported higher ratings with eligibility determination and scheduling initial appointments than their White and non-Hispanic counterparts, and Black Veterans reported higher ratings of care coordination, with adjusted differences of 0.05 to 0.21 SDs. Care ratings improved from 2016 to 2021, but differences between racial and ethnic groups persisted.

conclusionsThis study identified small but persistent racial and ethnic differences in Veterans' experiences with VA-funded community care, with Black and Hispanic Veterans reporting lower ratings in five domains and, respectively, higher ratings in three and two domains. Interventions to improve Black and Hispanic Veterans' patient experience could advance equity in VA community care.

Indexed as

Healthcare DisparitiesUnited States Department of Veterans AffairsVeteransAdultAgedCommunity Health ServicesEthnicityFemaleHealth Services AccessibilityHumansMaleMiddle AgedRacial GroupsUnited StatesVeterans Health Servicescommunity caredisparitiesVeteran Affairs

Identifiers

PMID38822210
PMCPMC11347541

What OpenQuestion holds

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LicenceCC BY
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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.