Does improving geographic access to VA primary care services impact patients' patterns of utilization and costs?
Does improving geographic access to VA primary care services impact patients' patterns of utilization and costs?
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DOI：
10.5034/inquiryjrnl_42.1.29
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发表时间：
2005-03-01
影响因子：
1.7
通讯作者：
Burgess, JF
中科院分区：
文献类型：
--
作者：
Fortney, JC;Maciejewski, ML;Burgess, JF
退伍军人事务部（VA）一直在全国各地建立社区门诊诊所（CBOCs），以改善退伍军人获得和使用初级保健服务的机会，从而减少对昂贵的专科门诊和住院护理的需求。使用准实验，前后研究设计，我们研究了CBOC的建立是否影响了访问，使用和VA患者居住在他们的集水区的成本。大多数居住在CBOC集水区的患者没有在CBOC接受护理，导致初级保健利用率仅略有增加。虽然CBOC改善了退伍军人的准入，但它们对利用和成本的总体模式影响甚微。
The Department of Veterans Affairs (VA) has been establishing community-based outpatient clinics (CBOCs) across the country to improve veterans' access to and use of primary care services, thereby decreasing the need for costly specialty outpatient and inpatient care. Using a quasi-experimental, pre-post study design, we examined whether the establishment of CBOCs has affected access, use, and costs for VA patients residing in their catchment areas. Most patients residing in CBOC catchment areas did not receive care at CBOCs, resulting in only small increases in primary care utilization. While CBOCs improved veterans' access, they had little impact on overall patterns of utilization and cost.