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AJPH First Look, published online ahead of print Oct 27, 2005
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AJPH.2004.061127v2
95/12/2246    most recent
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American Journal of Public Health, 10.2105/AJPH.2004.061127

Research and Practice

Changes in Veterans' Use of Outpatient Care From 1992 to 2000

Judith A. Long 1*, Daniel Polsky 2, Joshua P. Metlay 3

1 Philadelphia VA Center for Health Equity Research and Promotion
2 Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
3 Philadelphia Veterans Affairs Center for Health Equity Research and Promotion, Philadelphia, PA

* To whom correspondence should be addressed. E-mail: jalong{at}mail.med.upenn.edu.


  Abstract

Objectives. During the mid-1990s, the Veterans Health Administration (VHA) reorganized and placed greater emphasis on high-quality primary care. To determine whether the reorganization was associated with changes in patterns of outpatient VHA use, we sought to evaluate changes in characteristics of veterans who use VHA outpatient services between 1992 and 2000.

Methods. We merged 2 waves of the National Survey of Veterans to determine changes in patterns of outpatient care use. We evaluated the extent to which veterans who received outpatient care received that care from the VHA.

Results. The odds ratio for VHA-only outpatient care relative to non-VHA-only care in 2000 relative to 1992 was 1.75 (95% confidence interval [CI]=1.51, 2.04), and the odds ratio for dual relative to non-VHA-only care was 1.22 (95% CI=1.08, 1.37). Veterans who were older, had low incomes, and had no additional health insurance coverage were most likely to increase their use of VHA outpatient care.

Conclusions. Our results suggest that the VHA is increasingly serving veterans who have trouble accessing the private health care system.

Key Words: Health Care Facilities/Services, Insurance, Health Service Delivery, Socioeconomic Factors, Surveys




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