VA Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS), Salt Lake City, Utah, USA.
University of Utah School of Medicine, Salt Lake City, Utah, USA.
Health Serv Res. 2024 Oct;59(5):e14351. doi: 10.1111/1475-6773.14351. Epub 2024 Jul 28.
To understand Veterans Health Administration (VA) leaders' information and resource needs for managing post-9/11 Veterans' VA enrollment and retention.
Interviews conducted from March-May 2022 of VA Medical Center (VAMC) leaders (N = 27) across 15 sites, using stratified sampling based on VAMC characteristics: enrollment rates, number of recently separated Veterans in catchment area, and state Medicaid expansion status.
Interview questions were developed using Petersen et al.'s Factors Influencing Choice of Healthcare System framework as a guide. Interviews were transcribed verbatim, and two coders analyzed the interviews using Atlas.ti, a qualitative software program. Coders followed the qualitative coding philosophy developed by Crabtree and Miller, a process of developing codes for salient concepts as they are identified during the analysis process.
DATA COLLECTION/EXTRACTION METHODS: Two coders analyzed 22% (N = 6) of the interviews and discussed and adjudicated any discrepancies. One coder independently coded the remainder of the interviews.
Several key themes were identified regarding facilitators and barriers for VA enrollment including reputation for high-quality VA care, convenience of VA services, awareness of VA services and benefits, and VA mental health services. Nearly every VA leader actively used tools and data to understand enrollment and retention rates and sought to enroll and retain more Veterans. To improve the management of enrollment and retention, VA leaders would like data shared in an easily understandable format and the capability to share data between the VA and community healthcare systems.
Enrollment and retention information is important for healthcare leaders to guide their health system decisions. Various tools are currently being used to try to understand the data. However, a multifunctional tool is needed to better aggregate the data to provide VA leadership with key information on Veterans' enrollment and retention.
了解退伍军人事务部 (VA) 领导人管理 9/11 后退伍军人 VA 登记和保留所需的信息和资源。
2022 年 3 月至 5 月，对 15 个地点的 VA 医疗中心 (VAMC) 领导人（N=27）进行了访谈，采用基于 VAMC 特征的分层抽样：登记率、集水区内最近退伍军人人数和州医疗补助扩张状况。
访谈问题是根据 Petersen 等人的《影响医疗保健系统选择的因素》框架制定的。访谈逐字转录，两名编码员使用 Atlas.ti 分析访谈，这是一种定性软件程序。编码员遵循 Crabtree 和 Miller 开发的定性编码哲学，即随着分析过程中确定突出概念，为其开发代码的过程。
数据收集/提取方法：两名编码员分析了 22%（N=6）的访谈，并讨论和裁决了任何差异。一名编码员独立对其余访谈进行编码。
确定了 VA 登记的促进因素和障碍的几个关键主题，包括 VA 护理质量高的声誉、VA 服务的便利性、对 VA 服务和福利的认识以及 VA 心理健康服务。几乎每一位 VA 领导人都积极使用工具和数据来了解登记和保留率，并寻求登记和保留更多的退伍军人。为了改善登记和保留的管理，VA 领导人希望以易于理解的格式共享数据，并希望 VA 与社区医疗系统之间能够共享数据。
登记和保留信息对于医疗保健领导人指导他们的医疗系统决策非常重要。目前正在使用各种工具来尝试理解这些数据。然而，需要一个多功能工具来更好地汇总数据，以便向 VA 领导层提供有关退伍军人登记和保留的关键信息。
