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Rural Veterans’ Perspectives of Dual Care

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Abstract

The purpose of this study was to develop an in-depth understanding of the barriers and enablers of effective dual care (care obtained from the Veterans Health Administration [VHA] and the private health system) for rural veterans. Telephone interviews of a random sample of 1,006 veterans residing in rural Nebraska were completed in 2010. A high proportion of the rural veterans interviewed reported receiving dual care. The common reasons cited for seeking care outside the VHA (or VA [Veterans Administration]) included having an established relationship with a non-VA provider and distance to the nearest VA medical center. Almost half of the veterans who reported having a personal doctor or nurse reported that this was a non-VA provider. Veterans reported high levels of satisfaction with the quality of care they receive. Ordinal logistic regression models found that veterans who were Medicare beneficiaries, and who rated their health status higher had higher satisfaction with dual care. The reasons cited by the veterans for seeking care at the VHA (quality of VHA care, lower costs of VHA care, entitlement) and veterans perceptions about dual care (confused about where to seek care for different ailments, perceived lack of coordination between VA and non VA providers) were significant predictors of veterans’ satisfaction with dual care. This study will guide policymakers in the VA to design a shared care system that can provide seamless, timely, high quality and veteran centered care.

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Acknowledgments

The funding for this project was provided by the Department of Veterans Affairs, VA Nebraska—Western Iowa HCS, Omaha Division, Contract No. VA 263-BO-0102. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report. The views expressed are solely those of the authors and do not necessarily represent those of the Department of Veterans Affairs.

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Authors and Affiliations

  1. Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198-4350, USA

    Preethy Nayar, Bettye Apenteng, Peter Woodbridge & Ann Fetrick

  2. Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198-4350, USA

    Fang Yu

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  1. Preethy Nayar
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  2. Bettye Apenteng
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  3. Fang Yu
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  4. Peter Woodbridge
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  5. Ann Fetrick
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Correspondence to Preethy Nayar.

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Nayar, P., Apenteng, B., Yu, F. et al. Rural Veterans’ Perspectives of Dual Care. J Community Health 38, 70–77 (2013). https://doi.org/10.1007/s10900-012-9583-7

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  • DOI: https://doi.org/10.1007/s10900-012-9583-7

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