Licciardone J C
Department of Public Health and Preventive Medicine, Texas College of Osteopathic Medicine, Fort Worth 76107.
J Am Osteopath Assoc. 1990 Apr;90(4):331-6.
A mail survey was conducted in rural northeastern Missouri to study the factors affecting use of Veterans Administration (VA) outpatient medical services by older veterans. During the year preceding the survey, 39.6% of the 169 responding veterans had used VA outpatient facilities. Travel time, long waiting time at the clinic, and travel expense were the most common perceived barriers to use. However, these factors were generally poor predictors of use. The reported percentage of each perceived geographic or administrative barrier to use was consistently greater for previous users than for nonusers of these facilities. Multiple regression analysis revealed private medical insurance coverage to be the only significant predictor of use. Veterans with private medical insurance were more likely to receive ambulatory medical care from local providers than from the VA. The potential impact of removing perceived barriers to use in this population remains unclear.
在密苏里州东北部农村地区开展了一项邮件调查，以研究影响老年退伍军人使用退伍军人事务部（VA）门诊医疗服务的因素。在调查前一年，169名回复的退伍军人中有39.6%使用了VA门诊设施。出行时间、在诊所长时间等待以及交通费用是最常被提及的使用障碍。然而，这些因素通常并不能很好地预测使用情况。对于这些设施的既往使用者，报告的每种感知到的地理或行政使用障碍的比例始终高于非使用者。多元回归分析显示，私人医疗保险覆盖是唯一显著的使用预测因素。有私人医疗保险的退伍军人从当地医疗服务提供者处获得门诊医疗服务的可能性高于从VA获得服务的可能性。消除该人群中感知到的使用障碍的潜在影响仍不明确。
