ArticleJournal of general internal medicine2025
Resistance to Switching Health Care Institution Among Veterans Referred for VA-Purchased Care.
Article in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled 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.
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.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Why do people trust (or mistrust) health organizations? A systematic review.International journal for equity in health · 2026Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundLittle is known about how Veterans choose between receiving Veterans Affairs (VA)-paid health care from VA-direct care (care provided in VA facilities) vs. non-VA facilities (VA-purchased care).
objectiveTo evaluate Veterans' resistance to switch their hypothetical choice of health care institution with reasonable alterations in quality and access using Discrete Choice Experiments (DCE).
designWe conducted a nationwide survey among Veterans who had been offered a referral for VA-purchased care.
participantsOf the 12,547 Veterans we approached, 1253 (10.0%) respondents had evaluable data. MAIN MEASURES: We summarized DCE results. We evaluated the multi-variable adjusted association of travel time to the nearest VA facility (≤ 1 h vs. > 1 h) with resistance to switch health care institutions. We calculated predicted probabilities (PP) for resistance to switching and separately based on distrust in VA health care. KEY
resultsWhen respondents imagined their local VA facility was 1 h farther away than their local VA-purchased care facility, more than 60% chose VA-direct care for every quality and access improvement scenario (e.g., VA had higher quality of care). However, when all factors of care in both institutions were equal, up to 60% of respondents who initially chose VA-purchased care would not switch to VA-direct care for any incremental improvement in access and quality of VA-direct care. Travel time was not associated with high resistance to switching health care location (adjusted OR 1.1, 95% CI 0.8-1.4; p = .70). Respondents who originally chose VA-purchased care and had high distrust in VA had the highest predicted probabilities of resistance to switch (≤ 1 h travel time: PP 36%, CI 28-43%; > 1 h travel time: PP 42%, CI 34-49%).
conclusionsInterventions to increase Veterans choosing VA-direct care should improve Veterans' understanding of VA and non-VA quality and access and also improve trust in VA.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.