دورية أكاديمية
أعرض في EDS

The impact of patient-provider relationships on choosing between VA and VA-purchased care: A qualitative study of health care decision-making among rural veterans.

التفاصيل البيبلوغرافية
العنوان: The impact of patient-provider relationships on choosing between VA and VA-purchased care: A qualitative study of health care decision-making among rural veterans.
المؤلفون: Ball DD; Center for Access & Delivery Research and Evaluation (CADRE) and the VA Office of Rural Health (ORH) Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Health Care System, Iowa City, Iowa, USA., Sadler AG; Center for Access & Delivery Research and Evaluation (CADRE) and the VA Office of Rural Health (ORH) Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Health Care System, Iowa City, Iowa, USA.; Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA., Steffen MJ; Center for Access & Delivery Research and Evaluation (CADRE) and the VA Office of Rural Health (ORH) Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Health Care System, Iowa City, Iowa, USA., Paez MB; Center for Access & Delivery Research and Evaluation (CADRE) and the VA Office of Rural Health (ORH) Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Health Care System, Iowa City, Iowa, USA., Mengeling MA; Center for Access & Delivery Research and Evaluation (CADRE) and the VA Office of Rural Health (ORH) Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Health Care System, Iowa City, Iowa, USA.; Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
المصدر: The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association [J Rural Health] 2024 Jun; Vol. 40 (3), pp. 430-437. Date of Electronic Publication: 2023 Nov 09.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Blackwell Country of Publication: England NLM ID: 8508122 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1748-0361 (Electronic) Linking ISSN: 0890765X NLM ISO Abbreviation: J Rural Health Subsets: MEDLINE
أسماء مطبوعة: Publication: [Oxford, Eng.] : Blackwell
Original Publication: [Burlington, Vt.?] : Journal of Rural Health, c1985-
مواضيع طبية MeSH: Veterans*/psychology , Veterans*/statistics & numerical data , Qualitative Research* , Rural Population*/statistics & numerical data , Decision Making* , United States Department of Veterans Affairs*/organization & administration , United States Department of Veterans Affairs*/statistics & numerical data, Humans ; Middle Aged ; Male ; Female ; Adult ; Aged ; United States ; Interviews as Topic/methods
مستخلص: Purpose: Since the Choice Act in 2014, many Veterans have had greater options for seeking Veteran Affairs (VA)-purchased care in the community. We investigated factors that influence rural Veterans' decisions regarding where to seek care.
Methods: We utilized semi-structured telephone interviews to query Veterans living in rural or highly rural areas of Midwestern states about their health care options, preferences, and experiences. Interviews were recorded and transcribed, thematically coded, and deductively analyzed using a socioecological approach.
Findings: Forty rural Veterans (20 men/20 women) ages 28-76 years completed interviews in 2019. We found that rural Veterans often spoke about their relationships and interactions with providers as an important factor in deciding where to seek care. They expressed three socioecological qualities of patient-provider relationships that affected their decisions: (1) personal level-rural Veterans traveled longer distances for more compatible patient-provider relationships; (2) interpersonal level-they sought stable patient-provider relationships that encouraged familiarity, trust, and communication; and (3) organizational level-they emphasized shared identities and expertise that fostered a sense of belonging with their provider. Participants also described how impersonal interactions, status differences, and staff turnover impacted their choice of provider and were disruptive to patient-provider relationships.
Conclusions: Rural Veterans' interview responses suggest exploring innovative ways to measure socioecological dimensions (i.e., personal, interpersonal, and organizational) of access-related decisions and patient-provider relationships to better understand health care barriers and needs. Such measures align with the VA's Whole Health approach that emphasizes person-centered care and the value of social relationships to Veterans' health.
(Published 2023. This article is a U.S. Government work and is in the public domain in the USA.)
References: Congressional Budget Office. The Veterans Community Care Program: Background and Early Effects. Congressional Budget Office; 2021. Accessed March 15, 2021. https://www.cbo.gov/publication/57257.
Buzza C, Ono SS, Turvey C, et al. Distance is relative: unpacking a principal barrier in rural healthcare. J Gen Intern Med. 2011;26(2):648‐654. doi:10.1007/s11606‐011‐1762‐1.
Krejci LP, Carter K, Gaudet T. Whole health: the vision and implementation of personalized, proactive, patient‐driven health care for veterans. Med Care. 2014;52(Suppl 5):S5‐S8. doi:10.1097/MLR.0000000000000226.
Kullgren JT, Fagerlin A, Kerr EA. Completing the MISSION: a blueprint for helping veterans make the most of new choices. J Gen Intern Med. 2020;35(5):1567‐1570. doi:10.1007/s11606‐019‐05404‐w.
Mattocks KM, Cunningham KJ, Greenstone C, Atkins D, Rosen AK, Upton M. Innovations in community care programs, policies, and research. Med Care. 2021;59(Suppl 3):S229‐S231. doi:10.1097/MLR.0000000000001550.
Cordasco KM, Mengeling MA, Yano EM, Washington DL. Health and health care access of rural women veterans: findings from the National Survey of Women Veterans. J Rural Health. 2016;32(4):397‐406. doi:10.1111/jrh.12197.
Pettey WB, Wagner TH, Rosen AK, Beilstein‐Wedel E, Shwartz M, Vanneman ME. Comparing driving miles for department of veterans affairs–Delivered versus department of Veterans Affairs–purchased cataract surgery. Med Care. 2021;59(3):S307‐S313. doi:10.1097/MLR.0000000000001491.
Hynes DM, Edwards S, Hickok A, et al. Veterans’ use of Veterans Health Administration primary care in an era of expanding choice. Med Care. 2021;59(3):S292‐S300. doi:10.1097/MLR.0000000000001554.
Mattocks KM, Cunningham K, Elwy AR, et al. Recommendations for the evaluation of cross‐system care coordination from the VA state‐of‐the‐art working group on VA/non‐VA care. J Gen Intern Med. 2019;34(1):18‐23.
Miller CJ, Shin M, Pugatch M, Kim B. Veteran perspectives on care coordination between Veterans Affairs and community providers: a qualitative analysis. J Rural Health. 2021;37(2):437‐446. doi:10.1111/jrh.12526.
Lafferty M, Govier DJ, Golden SE, Disher NG, Hynes DM, Slatore CG. VA‐delivered or VA‐purchased care: important factors for Veterans navigating care decisions. J Gen Intern Med. 2023;38(7):1647‐1654. doi:10.1007/s11606‐023‐08128‐0.
VHA and ORH Adopt New System to Define “Rural”. Department of Veterans Affairs Office of Rural Health. Accessed December 11, 2021. https://www.ruralhealth.va.gov/rural‐definition.asp.
Data Downloads: Health Professional Shortage Areas (HPSAs), HPSA‐Primary Care. Health Resources and Services Administration. Accessed November 12, 2018. https://data.hrsa.gov/data/download.
Cheek J. An untold story: doing funded qualitative research. In: Denzin N, Lincoln Y, eds. Handbook for Qualitative Research. 2nd ed. Sage Publications; 2000:401‐420.
Charmaz K. Constructing Grounded Theory. 2nd ed. SAGE Publications Ltd; 2014.
Galvin R. How many interviews are enough? Do qualitative interviews in building energy consumption research produce reliable knowledge. J Build Eng. 2015;1:2‐12. doi:10.1016/j.jobe.2014.12.001.
Bernard HR, Gravlee CC, eds. Handbook of Methods in Cultural Anthropology. 2nd ed. Rowman & Littlefield Publishers; 2006.
Wolf ER. Distinguished lecture: facing power‐old insights, new questions. Am Anthropol. 1990;92(3):586‐596.
Wolf ER. Envisioning Power: Ideologies of Dominance and Crisis. University of California Press; 1999.
Waitzkin H. The Politics of Medical Encounters: How Patients and Doctors Deal with Social Problems. Yale University Press; 1991.
Nayar P, Apenteng B, Yu F, Woodbridge P, Fetrick A. Rural veterans’ perspectives of dual care. J Community Health. 2013;38(1):70‐77. doi:10.1007/s10900‐012‐9583‐7.
Pope CA, Davis BH, Wine L, et al. Perceptions of US Veterans Affairs and community healthcare providers regarding cross‐system care for heart failure. Chronic Illn. 2018;14(4):283‐296. doi:10.1177/1742395317729887.
Zander N, Dukart J, van den Berg N, Augustin J. Identifying determinants for traveled distance and bypassing in outpatient care: a scoping review. Inquiry. 2019;56:004695801986543. doi:10.1177/0046958019865434.
Weeks WB, Wallace AE, West AN, Heady HR, Hawthorne K. Research on rural veterans: an analysis of the literature. J Rural Health. 2008;24(4):337‐344. doi:10.1111/j.1748‐0361.2008.00179.x.
Statz M, Evers K. Spatial barriers as moral failings: what rural distance can teach us about women's health and medical mistrust. Health Place. 2020;64:102396. doi:10.1016/j.healthplace.2020.102396.
Douthit N, Kiv S, Dwolatzky T, Biswas S. Exposing some important barriers to health care access in the rural USA. Public Health. 2015;129(6):611‐620. doi:10.1016/j.puhe.2015.04.001.
Moscovice S. Rural hospitals: a literature synthesis and health services research agenda. Health Serv Res. 1989;23(6):891‐930.
Government Accountability Office. Veterans Health Administration: Actions Needed to Better Recruit and Retain Clinical and Administrative Staff (GAO‐17‐475T). Government Accountability Office; 2017. Accessed December 17, 2022. https://www.gao.gov/assets/gao‐17‐475t.pdf.
Government Accountability Office. VA Health Care: Oversight Improvements Needed for Nurse Recruitment and Retention Initiatives (GAO‐15‐794). Government Accountability Office; 2015. Accessed December 17, 2022. https://www.gao.gov/assets/gao‐15‐794.pdf.
Johnson NL, Steffensmeier KS, Garvin LA, et al. “It made me not want to see him…”: the role of patient‐provider communication in influencing rural‐dwelling women Veterans' motivation to seek health care for managing chronic pain. Health Commun. 2023;10:1‐14. doi: 10.1080/10410236.2023.2207280.
Scott JG, Cohen D, DiCicco‐Bloom B, et al. Understanding healing relationships in primary care. Ann Fam Med. 2008;6(4):315‐322. doi:10.1370/afm.860.
Kamimura A, Higham R, Rathi N, Panahi S, Lee E, Ashby J. Patient–provider relationships among vulnerable patients: the association with health literacy, continuity of care, and self‐rated health. J Patient Exp. 2020;7(6):1450‐1457. doi:10.1177/2374373519895680.
Farkas AH, Merriam S, Frayne S, Hardman L, Schwartz R, Kolehmainen C. Retaining providers with women's health expertise: decreased provider loss among VHA women's health faculty development program attendees. J Gen Intern Med. 2022;37(3):786‐790. doi:10.1007/s11606‐022‐07575‐5.
Angier H, Gregg J, Gold R, et al. Understanding how low‐income families prioritize elements of health care access for their children via the optimal care model. BMC Health Serv Res. 2014;14(1):585. doi:10.1186/s12913‐014‐0585‐2.
Fan VS, Burman M, McDonell MB, Fihn SD. Continuity of care and other determinants of patient satisfaction with primary care. J Gen Intern Med. 2005;20(3):226‐233. doi:10.1111/j.1525‐1497.2005.40135.x.
Bohnert ASB, Zivin K, Welsh DE, Kilbourne AM. Ratings of patient–provider communication among veterans: serious mental illnesses, substance use disorders, and the moderating role of trust. Health Commun. 2011;26(3):267‐274. doi:10.1080/10410236.2010.549813.
Carlson GC, Than CT, Rose D, et al. What drives women veterans’ trust in VA healthcare providers. Womens Health Issues. 2022;32(5):499‐508. doi:10.1016/j.whi.2022.02.004.
Dang BN, Westbrook RA, Njue SM, Giordano TP. Building trust and rapport early in the new doctor‐patient relationship: a longitudinal qualitative study. BMC Med Educ. 2017;17(1):32. doi:10.1186/s12909‐017‐0868‐5.
McMillan DW. Sense of community. J Community Psychol. 1996;24(4):315‐325.
Kaboli PJ, Shivapour DM, Henderson MS, Barnett MJ, Ishani A, Carter BL. Patient and provider perceptions of hypertension treatment: do they agree. J Clin Hypertens (Greenwich). 2007;9(6):416‐423. doi:10.1111/j.1524‐6175.2007.06492.x.
Buzza CD, Williams MB, Vander Weg MW, Christensen AJ, Kaboli PJ, Reisinger HS. Part II, provider perspectives: should patients be activated to request evidence‐based medicine? A qualitative study of the VA project to implement diuretics (VAPID). Implement Sci. 2010;5:24. doi:10.1186/1748‐5908‐5‐24.
Moreau JL, Dyer KE, Hamilton AB. Women veterans' perspectives on how to make Veterans Affairs healthcare settings more welcoming to women. Womens Health Issues. 2020;30(4):299‐305. doi:10.1016/j.whi.2020.03.004.
Lafferty M, Strange W, Kaboli P, Tuepker A, Teo AR. Patient sense of belonging in the Veterans Health Administration: a qualitative study of appointment attendance and patient engagement. Med Care. 2022;60(9):726‐732. doi:10.1097/MLR.0000000000001749.
Chen JI, Ono SS, Laliberte AZ, Roth B, Dobscha SK. Veteran community engagement and social connection needs following inpatient psychiatric hospitalization. Psychiatr Rehabil J. 2022;45(4):324‐330. doi:10.1037/prj0000534.
Koenig CJ, Maguen S, Monroy JD, Mayott L, Seal KH. Facilitating culture‐centered communication between health care providers and veterans transitioning from military deployment to civilian life. Patient Educ Couns. 2014;95(3):414‐420. doi:10.1016/j.pec.2014.03.016.
Foucault M. The Birth of Clinic: An Archaeology of Medical Perception. Vintage Books; 1973.
Starr P. The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry. 1st ed. Basic Books; 2017.
Lock MM, Nguyen VK. An Anthropology of Biomedicine. 2nd ed. John Wiley & Sons; 2018.
Gaudet T, Kligler B. Whole health in the whole system of the veterans administration: how will we know we have reached this future state. J Altern Complement Med. 2019;25(S1):S7‐S11. doi:10.1089/acm.2018.29061.gau.
Kligler B, Hyde J, Gantt C, Bokhour B. The whole health transformation at the Veterans Health Administration: moving from “what's the matter with you?” to “what matters to you?”. Med Care. 2022;60(5):387‐391. doi:10.1097/MLR.0000000000001706.
Abadi M, Richard B, Shamblen S, et al. Achieving whole health: a preliminary study of tcmlh, a group‐based program promoting self‐care and empowerment among veterans. Health Educ Behav. 2022;49(2):347‐357. doi:10.1177/10901981211011043.
Gordon HS, Street RL, Sharf BF, Souchek J. Racial differences in doctors' information‐giving and patients' participation. Cancer. 2006;107(6):1313‐1320. doi:10.1002/cncr.22122.
Spoont M, Nelson D, van Ryn M, Alegria M. Racial and ethnic variation in perceptions of VA mental health providers are associated with treatment retention among veterans with PTSD. Med Care. 2017;55(Suppl Suppl92):S33‐S42. doi:10.1097/MLR.0000000000000755.
Eliacin J, Matthias MS, Cunningham B, Burgess DJ. Veterans’ perceptions of racial bias in VA mental healthcare and their impacts on patient engagement and patient‐provider communication. Patient Educ Couns. 2020;103(9):1798‐1804. doi:10.1016/j.pec.2020.03.017.
Ormond BA, Zuckerman S, Lhila A. Rural/urban differences in health care are not uniform across states. New Federalism: National Survey of America's Families. The Urban Institute; 2000. May. Series B, No. B‐11.
Schroeder S. Rural Communities: Age, Income, and Health Status. Rural Health Research RECAP; 2018. Accessed July 20, 2023. https://www.ruralhealthresearch.org/assets/2200‐8536/rural‐communities‐age‐income‐health‐status‐recap.pdf.
Baum A, Kaboli PJ, Schwartz MD. Reduced in‐person and increased telehealth outpatient visits during the COVID‐19 pandemic. Ann Internal Med. 2021;174(1):129‐131. doi:10.7326/M20‐3026.
Connolly SL, Stolzmann KL, Heyworth L, et al. Rapid increase in telemental health within the department of Veterans Affairs during the COVID‐19 pandemic. Telemed J E Health. 2021;27(4):454‐458. doi:10.1089/tmj.2020.0233.
معلومات مُعتمدة: U.S. Department of Veterans Affairs; Office of Rural Health
فهرسة مساهمة: Keywords: access to care; health care decision‐making; patient–provider relationships; quality of care; rural veterans
تواريخ الأحداث: Date Created: 20231109 Date Completed: 20240619 Latest Revision: 20240619
رمز التحديث: 20240619
DOI: 10.1111/jrh.12804
PMID: 37942663
قاعدة البيانات: MEDLINE
الوصف
تدمد:1748-0361
DOI:10.1111/jrh.12804