Factors related to attrition from VA healthcare use: findings from the National Survey of Women Veterans.
Factors related to attrition from VA healthcare use: findings from the National Survey of Women Veterans.
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DOI：
10.1007/s11606-013-2347-y
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发表时间：
2013-07
影响因子：
5.7
通讯作者：
Washington, Donna L.
中科院分区：
文献类型：
--
作者：
Hamilton, Alison B.;Frayne, Susan M.;Cordasco, Kristina M.;Washington, Donna L.
虽然之前的研究描述了女性退伍军人在获得和使用退伍军人健康管理局（VA）护理方面的障碍，但很少有人关注那些获得退伍军人健康管理局和使用服务，但后来停止使用的女性。最近的数据表明，在女性退伍军人中，在最初使用VA的三年内有30%的流失率。比较女性退伍军人退伍军人减损者（停止使用）和非减损者（继续使用）之间的个体特征和对退伍军人护理的看法，并比较最近和远程减损者。2008-2009年全国基于人口的横断面电话调查。626名退伍军人和2065名非退伍军人参与了全国女性退伍军人调查。人口加权的人口、军事和健康特征；对退伍军人医疗保健的看法；自上次使用VA后的时间长度；在服兵役者中，有不再使用退伍军人护理的理由。54%的加权VA用户报告说他们不再使用VA。45%的流失发生在过去的十年里。与非减损者相比，减损者总体健康状况更好（p = 0.007），收入更高（p < 0.001），并且更有可能拥有健康保险（p < 0.001）。减减员对退伍军人的积极看法低于非减减员，减减员对退伍军人质量和退伍军人护理的性别特征的评分较低（p < 0.001）。从2001年开始停止使用退伍军人服务的女性退伍军人与那些长期使用退伍军人服务的女性退伍军人在大多数退伍军人服务感知指标上没有差异。总体而言，在服兵役者中，距离退伍军人护理地点的距离和有替代保险覆盖是停止使用退伍军人服务的最常见原因。尽管最近在退伍军人护理方面取得了进展，但我们发现退伍军人的流失率很高。退伍军人事务部的女性流失可能会减少退伍军人事务部女性退伍军人的临界数量，并影响目前为退伍军人提供高质量护理的全系统努力。了解流失的原因可以告知组织努力重新吸引已经流失的女性，保留现有用户，并可能吸引新的VA患者。
While prior research characterizes women Veterans’ barriers to accessing and using Veterans Health Administration (VA) care, there has been little attention to women who access VA and use services, but then discontinue use. Recent data suggest that among women Veterans, there is a 30 % attrition rate within 3 years of initial VA use. To compare individual characteristics and perceptions about VA care between women Veteran VA attriters (those who discontinue use) and non-attriters (those who continue use), and to compare recent versus remote attriters. Cross-sectional, population-based 2008–2009 national telephone survey. Six hundred twenty-six attriters and 2,065 non-attriters who responded to the National Survey of Women Veterans. Population weighted demographic, military and health characteristics; perceptions about VA healthcare; length of time since last VA use; among attriters, reasons for no longer using VA care. Fifty-four percent of the weighted VA ever user population reported that they no longer use VA. Forty-five percent of attrition was within the past ten years. Attriters had better overall health (p = 0.007), higher income (p < 0.001), and were more likely to have health insurance (p < 0.001) compared with non-attriters. Attriters had less positive perceptions of VA than non-attriters, with attriters having lower ratings of VA quality and of gender-specific features of VA care (p < 0.001). Women Veterans who discontinued VA use since 2001 did not differ from those with more remote VA use on most measures of VA perceptions. Overall, among attriters, distance to VA sites of care and having alternate insurance coverage were the most common reasons for discontinuing VA use. We found high VA attrition despite recent advances in VA care for women Veterans. Women’s attrition from VA could reduce the critical mass of women Veterans in VA and affect current system-wide efforts to provide high-quality care for women Veterans. An understanding of reasons for attrition can inform organizational efforts to re-engage women who have attrited, to retain current users, and potentially to attract new VA patients.
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影响因子：
5
作者：
KASTELER, J;KANE, RL;THETFORD, C
通讯作者：
THETFORD, C
影响因子：
3.2
作者：
Friedman, Sarah A.;Phibbs, Ciaran S.;Frayne, Susan M.
通讯作者：
Frayne, Susan M.
DOI：
10.1001/archfami.7.4.352
发表时间：
1998-07-01
期刊：
ARCHIVES OF FAMILY MEDICINE
影响因子：
--
作者：
Gill, JM;Mainous, AG
通讯作者：
Mainous, AG
DOI：
10.2307/3349613
发表时间：
1973-01-01
期刊：
MILBANK MEMORIAL FUND QUARTERLY-HEALTH AND SOCIETY
影响因子：
--
作者：
ANDERSEN, R;NEWMAN, JF
通讯作者：
NEWMAN, JF
影响因子：
3
作者：
MARQUIS, MS;DAVIES, AR;WARE, JE
通讯作者：
WARE, JE