VA Palo Alto Health Care System, Menlo Park, CA, USA.
University of California San Francisco School of Medicine, San Francisco, CA, USA.
Med Care Res Rev. 2024 Feb;81(1):58-67. doi: 10.1177/10775587231194681. Epub 2023 Sep 7.
Veterans enrolled in the Veterans Affairs (VA) health care system gained greater access to non-VA care beginning in 2014. We examined hospital and Veteran characteristics associated with hospital choice. We conducted a longitudinal study of elective hospitalizations 2011 to 2017 in 11 states and modeled patients' choice of VA hospital, large non-VA hospital, or small non-VA hospital in conditional logit models. Patients had higher odds of choosing a hospital with an academic affiliation, better patient experience rating, location closer to them, and a more common hospital type. Patients who were male, racial/ethnic minorities, had higher VA enrollment priority, and had a mental health comorbidity were more likely than other patients to choose a VA hospital than a non-VA hospital. Our findings suggest that patients respond to certain hospital attributes. VA hospitals may need to maintain or achieve high levels of quality and patient experience to attract or retain patients in the future.
自 2014 年以来，加入退伍军人事务部（VA）医疗保健系统的退伍军人获得了更多获得非退伍军人医疗保健的机会。我们研究了与医院选择相关的医院和退伍军人特征。我们在 11 个州对 2011 年至 2017 年的选择性住院进行了纵向研究，并在条件逻辑回归模型中对患者选择退伍军人医院、大型非退伍军人医院或小型非退伍军人医院的情况进行了建模。患者选择有学术附属关系、患者体验评分更好、距离更近以及更常见的医院类型的医院的可能性更高。与其他患者相比，男性、少数族裔、退伍军人事务部登记优先级较高且存在心理健康合并症的患者更有可能选择退伍军人医院而非非退伍军人医院。我们的研究结果表明，患者对某些医院特征做出了反应。退伍军人事务部医院将来可能需要保持或达到高水平的质量和患者体验，以吸引或留住患者。
