Motivators, Barriers, and Facilitators to Choosing Care in VA Facilities Versus VA-Purchased Care
The research investigates the factors influencing Veterans' choices between receiving care at VA facilities and VA-purchased care from non-VA providers. It finds that quality of care is a primary motivator, while distrust and travel distance significantly affect the likelihood of choosing VA facilities, with those living far from VA centers and experiencing high distrust being less likely to choose VA care.
College of Health researcher(s)
Abstract
Many Veterans receive Department of Veterans Affairs (VA)-purchased care from non-VA facilities but little is known about factors that Veterans consider for this choice. Between May 2020 and August 2021, we surveyed VA-purchased care-eligible VA patients about barriers and facilitators to choosing where to receive care. We examined the association between travel time to their VA facility and their choice of VA-purchased care (VA-paid health care received in non-VA settings) versus VA facility and whether this association was modified by distrust. We received 1,662 responses and 692 (42%) chose a VA facility. Eighty percent reported quality care was in their top three factors that influenced their decision. Respondents with the highest distrust and who lived >1 hr from the nearest VA facility had the lowest predicted probability (PP) of choosing VA (PP 15%; 95% confidence interval: 10%–20%). Veterans value quality of care. VA and other health care systems should consider patient-centered ways to improve and publicize quality and reduce distrust.