Observational studyJournal of general internal medicine2026
Racial and Ethnic Differences in Healthcare Experiences for Veterans Receiving Care from VA and Non-VA Providers.
Observational study in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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2 authors.
Funding
Abstract
backgroundVeterans increasingly receive care from both Veterans Affairs (VA) and non-VA providers, creating challenges for care coordination. Limited research has examined racial/ethnic disparities in Veterans' healthcare experiences across these dual systems.
objectiveTo examine racial/ethnic differences in the healthcare experiences of Veterans regarding provider knowledge of past health problems, maintenance of complete health records, and cross-system awareness, and determine whether disparities differ between VA and non-VA settings.
designCross-sectional analysis using generalized estimating equations to estimate the differences in positive experiences and decomposition analysis to identify factors explaining disparities.
participantsIn total, 1885 unique Veterans contributing 2568 respondent-years from the 2018-2019 Medical Expenditure Panel Survey Veteran Self-Administered Questionnaire, representing approximately 15.5 million Veteran-years nationally. MAIN MEASURES: Three self-reported patient experience outcomes: provider knowledge of past health problems, maintenance of complete health records, and provider awareness of care received in other systems. KEY
resultsNon-Hispanic White Veterans reported more positive experiences than Black and Hispanic Veterans for provider knowledge (77.9% vs 62.0% and 61.1%) and record completeness (86.6% vs 72.9% and 67.2%). Disparities were larger in non-VA settings, particularly for record completeness, where the Black-White disparity was 15.5 percentage points larger in non-VA versus VA settings (95% CLs 4.4, 26.6). Cross-system awareness was uniformly low (10-15%) across all groups. Decomposition analysis revealed demographics explained 7.7 percentage points of Hispanic-White disparities in record completeness.
conclusionsAlthough disparities were smaller within VA than non-VA settings, meaningful gaps persist. Targeted interventions to improve care coordination and information sharing, especially in non-VA settings, are needed as community care expands. CLINICAL TRIAL NUMBER: Not applicable.
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