Optimizing Veteran Decision-Making About Use of VA and Non-VA Health Care

优化退伍军人关于使用 VA 和非 VA 医疗保健的决策

• 批准号: 10114139
• 负责人: JEFFREY KULLGREN
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10114139
• 关键词: Acceleration; Caring; Characteristics; Communities; Community Healthcare; Community Networks; Complex; Decision Making; Deductibles; Eligibility Determination; Evolution; Focus Groups; Geography; Health; Healthcare; Healthcare Systems; Interview; Learning; Low income; Measures; Medicaid; Methodology; Methods; Participant; Perception; Policies; Policy Analysis; Privatization; Process; Provider; Qualitative Methods; Reporting; Research; Resource Allocation; Sampling; Science; Services; Source; Statutes and Laws; Structure; Surveys; System; Translations; United States Department of Veterans Affairs; Veterans; Veterans Health Administration; Work; care preference; design; experience; health care cost/financing; health care service; health care settings; health plan; improved; innovation; insight; patient oriented; patient population; personalized decision; programs; public health insurance; success

Background: Major health care transformations within and outside of VA are now providing Veterans with unprecedented health care choices. Within VA, under recent federal legislation integrated networks of community providers and public reporting of access and quality at VA facilities are aiming to expand health care choices for Veterans and improve the timeliness of services. Outside of VA, many lower-income Veterans in states that expanded Medicaid now have a public insurance option, while privately-insured Veterans are increasingly facing high deductibles in their health plans. Significance/Impact: Major shifts in health care financing and delivery present Veterans with opportunities to make decisions about their use of VA and non-VA health care that optimize the timeliness, affordability, quality, and patient-centeredness of their care. However, these decisions also carry great potential for unintended consequences if they are not well-informed. Despite such high stakes, little is known about how Veterans are making decisions about using VA and non-VA care, what information they want to use in this decision-making, and how provision of information to Veterans about their health care options could be improved. Understanding these issues is critical to the success of national efforts to expand health care choices for Veterans under the VA MISSION Act and to achieve a VA health care system that is maximally responsive to Veterans’ needs. Innovation: This study is the first to assess the views, experiences, and information needs of Veterans who are users and non-users of VA health care. Specific Aims: Aim 1: Examine how Veterans are making decisions about VA and non-VA care and what information they want to use when making these decisions. Aim 2: Identify correlates of Veterans’ decisions to use and experiences with using VA and non-VA health care. Aim 3: Engage Veterans and VA leaders to identify opportunities to optimize Veterans’ decisions about use of VA and non-VA care and VA’s responsiveness to Veterans’ health care preferences. Methodology: We will partner with Veterans organizations to conduct focus groups and semi-structured interviews that will examine decision-making experiences of Veterans who use VA care, non-VA care, or both; the sources of information Veterans have used and would want to use in this decision-making; and Veterans’ experiences with the timeliness, affordability, quality, and patient-centeredness of VA and non-VA care. We will use these findings to develop and field a national survey of Veterans’ use of and decision-making about VA and non-VA care; factors related to their decision-making and health needs; and perceptions of the timeliness, affordability, quality, and patient-centeredness of their health care. The nationally representative sample of 3,000 Veterans will include both users and non-users of VA health care. We will identify Veteran characteristics associated with use of VA and non-VA health care services and with their health care experiences in VA and community health care settings. Finally, we will conduct deliberative forums with Veterans and VA operational leaders to develop actionable strategies that can be used to support Veterans’ decisions about VA and non-VA health care. Using a combination of deliberation and design methods, we will share key findings from the first 2 Aims and then guide participants through a collaborative process in which they will identify and prioritize programs and policies that could support Veteran decision-making about use of VA and non-VA care. Next Steps/Implementation: Products will include a compendium of the types of information Veterans use and need for decision-making about VA and non-VA care, new survey measures to assess Veterans’ decisions about VA and non-VA care, and a prioritized list of programs and policies that could be implemented to help Veterans make decisions about VA and non-VA care. We will use these products to work with our VA and non- VA partners to develop new strategies to optimize Veteran decision-making about VA and non-VA care.

背景：VA内外的主要医疗保健转型正在为退伍军人提供 在弗吉尼亚州内的未经预言的医疗保健选择。 社区提供商以及VA设施的访问和质量的公开报告旨在扩大健康状况 对退伍军人的护理选择并改善服务的时间表。 在扩大医疗补助的州中 在其健康计划中，越来越面对高额扣除额。 意义/影响力：医疗保健融资和交付的重大转变也为退伍军人提供了机会 决定开放时间表，负担能力，质量，质量的VA和VA医疗保健的使用。 和以患者为中心的护理。 后果尽管有如此高的赌注，但对退伍军人来说知之甚少？ 对VA和非VA护理做出决定，他们想在决策中使用哪些信息， 以及如何为退伍军人提供有关其医疗保健选择的信息。 这些问题对对方对自然epides至关重要，以表达退伍军人的选择 VA Mission Act并实现对退伍军人需求的最大响应的VA医疗保健系统。 创新：这项研究是第一个评估退伍军人的观点，经验和信息需求的研究 是VA医疗保健的用户和非用户。 具体目的：目标1：检查退伍军人如何决定VA和VA护理护理护理护理护理护理护理护理 他们想在这些决定时使用的信息2：确定退伍军人的决定的相关性 使用VA和VA医疗保健的经验3：与退伍军人和VA领导人 确定优化退伍军人对VA和VA护理护理护理使用的决定的机会 对退伍军人的卫生保健偏好的努力。 方法论：我们将与退伍军人合作，进行焦点小组和半结构化 访谈将检查使用VA护理，非VA护理或两者兼而有之的退伍军人的决策决定。 退伍军人使用的信息的来源将会在这一决策和退伍军人中使用； 我们将获得时间表，负担能力，质量和以患者为中心的经验 使用调查结果来制定和实施国家对退伍军人对VA的使用和决策的调查 和非VA护理； 负担能力，质量和以患者为中心的医疗保健。 3000名退伍军人将包括VA医疗保健的用户和非用户。 与VA和VA医疗保健服务以及VA和VA的医疗保健经验有关 最终，我们将与退伍军人和弗吉尼亚州运营进行协商论坛 领导者制定可行的策略，这些策略可用于支持退伍军人对VA和NON-VA的决定 卫生保健。 目的，然后指导参与者通过合作过程，他们将确定并确定优先级 可以支持关于UF VA和VA护理的资深决策的计划和政策。 下一步/实施：产品将不列出退伍军人使用的信息类型 并需要有关VA和非VA护理的决策，这是评估退伍军人决策的新调查措施 关于VA和非VA护理，以及实施以帮助的计划和政策的优先级清单 退伍军人对VA和非VA护理做出决定。 VA合作伙伴制定新策略，以优化有关VA和VA护理的资深决策。