Comparing Driving Miles for Department of Veterans Affairs-delivered Versus Department of Veterans Affairs-purchased Cataract Surgery.
Comparing Driving Miles for Department of Veterans Affairs-delivered Versus Department of Veterans Affairs-purchased Cataract Surgery.
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DOI：
10.1097/mlr.0000000000001491
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发表时间：
2021-06-01
期刊：
影响因子：
3
通讯作者：
Vanneman ME
中科院分区：
文献类型：
--
作者：
Pettey WBP;Wagner TH;Rosen AK;Beilstein-Wedel E;Shwartz M;Vanneman ME
补充数字内容可在文本中找到。2014年的退伍军人选择法案增加了有资格获得退伍军人事务部（VA）购买的非VA社区护理（CC）设施提供的护理的退伍军人人数。驾驶> 40英里从家到VA设施是CC的关键资格标准。目前尚不清楚这一政策变化是否通过减少退伍军人的驾车距离来改善地理位置。描述退伍军人在VA和CC设施接受白内障手术的驾驶距离，以及他们是否访问了离家最近的设施或他们是否开车到更远的设施。2015年联邦财政年度做过白内障手术的退伍军人。我们计算了到最近的VA和CC设施进行白内障手术的驾驶里程，以及到退伍军人接受护理的地点。共有61，746名退伍军人接受了83，875例白内障手术。超过50%的CC手术发生在距离提供白内障手术的最近CC设施更远的地方（最近CC设施的中位数为8.7英里，而实际CC设施为19.7英里）。大多数（57%）在VA机构接受白内障手术的退伍军人使用最近的VA机构（中位数最近的VA机构为28.1英里，实际VA机构为31.2英里）。总的来说，26.1%的CC程序发生在比最近的VA设施更远的设施中。虽然许多退伍军人开车比需要得到白内障手术在CC，这是不正确的获得照顾在VA。我们的研究结果表明，除了驾驶距离之外，可能还有其他原因影响退伍军人是否选择CC，如果他们选择CC，他们在哪里寻求CC。
Supplemental Digital Content is available in the text. The Veterans Choice Act of 2014 increased the number of Veterans eligible for Department of Veterans Affairs (VA)-purchased care delivered in non-VA community care (CC) facilities. Driving >40 miles from home to a VA facility is a key eligibility criterion for CC. It remains unclear whether this policy change improved geographical access by reducing drive distance for Veterans. Describe the driving distance for Veterans receiving cataract surgery in VA and CC facilities, and if they visited the closest-to-home facility or if they drove to farther facilities. Veterans who had cataract surgery in federal fiscal year 2015. We calculated driving miles to the Closest VA and CC facilities that performed cataract surgeries, and to the location where Veterans received care. A total of 61,746 Veterans received 83,875 cataract surgeries. More than 50% of CC surgeries occurred farther than the Closest CC facility providing cataract surgery (median Closest CC facility 8.7 miles vs. Actual CC facility, 19.7 miles). Most (57%) Veterans receiving cataract surgery at a VA facility used the Closest VA facility (median Closest VA facility 28.1 miles vs. Actual VA facility at 31.2 miles). In all, 26.1% of CC procedures occurred in facilities farther away than the Closest VA facility. Although many Veterans drove farther than needed to get cataract surgery in CC, this was not true for obtaining care in the VA. Our findings suggest that there may be additional reasons, besides driving distance, that affect whether Veterans choose CC and, if they do, where they seek CC.