VA-Community Dual Care: Veteran and Clinician Perspectives.
Many veterans receive care in both community settings and the VA. Recent legislation has increased veteran access to community providers, raising concerns about safety and coordination. This project aimed to understand the benefits and challenges of dual care from the perceptions of both the Veterans their clinicians. We conducted surveys and focus groups of veterans who use both VA and community care in VT and NH. We also conducted a web-based survey and a focus group involving primary care clinicians from both settings. The main measures included (1) reasons that veterans seek care in both settings; (2) problems faced by veterans and clinicians; (3) association of health status and ease of managing care with sites of primary care; and (4) association of veteran rurality with dual care experiences. The primary reasons veterans reported for using both VA and community care were (1) for convenience, (2) to access needed services, and (3) to get a second opinion. Veterans reported that community and VA providers were informed about the others' care more than half the time. Veterans in isolated rural towns reported better overall health and ease of managing their care. VA and community primary care clinicians reported encountering systems problems with dual-care including communicating medication changes, sharing lab and imaging results, communicating with specialists, sharing discharge summaries and managing medication renewals. Both Veterans and their primary clinicians report substantial system issues in coordinating care between the VA and the community, raising the potential for significant patient safety and Veteran satisfaction concerns.
['Schlosser|James|J|0000-0002-5732-5442', 'Kollisch|Donald|D|', 'Johnson|Deborah|D|', 'Perkins|Troi|T|', 'Olson|Ardis|A|']
D005260:Female D006304:Health Status D006801:Humans D036301:Qualitative Research D012017:Referral and Consultation D012424:Rural Population D011795:Surveys and Questionnaires D014481:United States D014493:United States Department of Veterans Affairs D014728:Veterans D000081324:Veterans Health Services
Dual care Veterans Primary care Care coordination Rural care