Abstract

BackgroundThe Department of Veterans Affairs' Veterans Health Administration (VHA) provides a health care safety net to veterans. This study examined changes in characteristics of veterans using the VHA health care system between 1996 and 1999 when VHA implemented major organizational changes to improve access of ambulatory care and to provide care to more veterans.MethodsThe study used two cross-sectional samples of the Medical Expenditures Panel Survey (MEPS), a national representative survey, in 1996 and 1999. The 1996 MEPS survey included 1,944 veterans and the 1999 MEPS survey included 1,974 veterans. There were 534 veterans and 740 veterans who used VHA services in 1996 and 1999, respectively.ResultsThe proportion of veterans using the VHA system increased from 12.4% in 1996 to 14.6% in 1999. In both years, veterans were more likely to use VHA care if they were older, male, less educated, uninsured, unemployed, and in fair or poor health status. Only two variables, marital status and income, were different between the two years. Married veterans were more likely to use VHA care in 1999, but not in 1996. Veterans with higher incomes had greater odds of using VHA care in 1996, but there was no significant association between income and VHA use in 1999.ConclusionCharacteristics of VHA users did not fundamentally change despite the reorganization of VHA health care delivery system and changes in eligibility and enrollment policy. The VHA system maintains its safety net mission while attracting more veterans.

Highlights

  • The Department of Veterans Affairs' Veterans Health Administration (VHA) provides a health care safety net to veterans

  • Proportion of Veterans Using the VHA System The percentage of veterans using the VHA system increased from 12.4% in 1996 to 14.6% in 1999 (p = 0.03)

  • We provided an overview of changes in health insurance status and demographic characteristics of veterans using the VHA health care system during a period when VHA implemented major organizational changes between 1996 and 1999

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Summary

Introduction

The Department of Veterans Affairs' Veterans Health Administration (VHA) provides a health care safety net to veterans. Veterans have access to a health care system unavailable to most Americans – the Veterans Health Administration (VHA), part of the Department of Veterans Affairs. This large, integrated health care system provided care to about 4.5 million veterans in 2002. The VHA has implemented significant organizational changes in recent years as mandated by the Veterans Eligibility Reform Act of 1996 [2]. The reorganization of the VHA aimed to shift the focus of care from inpatient to outpatient settings, to improve access to ambulatory care, and to provide care to more veterans.

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