Information and resources VA health system leaders need to manage enrollment and retention for Post-9/11 veterans

IF 3.1 2区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Todd Brown MSc, Angela Fagerlin PhD, Matthew H. Samore MD, Alex H. S. Harris PhD, Patrick Galyean BS, Susan Zickmund PhD, Warren B. P. Pettey MPH, CPH, Megan E. Vanneman PhD, MPH
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引用次数: 0

Abstract

Objective

To understand Veterans Health Administration (VA) leaders' information and resource needs for managing post-9/11 Veterans' VA enrollment and retention.

Data Sources and Study Setting

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.

Study Design

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.

Principal Findings

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.

Conclusions

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.

退伍军人事务部医疗系统领导者在管理 9/11 后退伍军人的注册和保留方面所需的信息和资源。
目标:了解退伍军人健康管理局(VA)领导在管理 9/11 事件后退伍军人的退伍军人注册和保留方面的信息和资源需求:2022 年 3 月至 5 月对 15 个地点的退伍军人医疗中心(VAMC)领导(N = 27)进行了访谈,访谈根据退伍军人医疗中心的特点进行分层抽样:注册率、覆盖区域内最近离职退伍军人的数量以及州医疗补助扩展状况:访谈问题以 Petersen 等人的 "影响医疗保健系统选择的因素 "框架为指导。访谈内容被逐字记录,两名编码员使用定性软件 Atlas.ti 对访谈内容进行分析。编码者遵循 Crabtree 和 Miller 提出的定性编码理念,即在分析过程中发现突出概念时,为其制定编码:两名编码员分析了 22% 的访谈(N = 6),并讨论和裁定了任何差异。一名编码员对其余的访谈进行了独立编码:在退伍军人登记的促进因素和障碍方面确定了几个关键主题,包括退伍军人高质量医疗服务的声誉、退伍军人服务的便利性、对退伍军人服务和福利的认识以及退伍军人心理健康服务。几乎每一位退伍军人事务部的领导都积极利用各种工具和数据来了解入学率和保留率,并努力招收和保留更多的退伍军人。为了改进对注册和保留率的管理,退伍军人事务部的领导希望以易于理解的格式共享数据,并能够在退伍军人事务部和社区医疗保健系统之间共享数据:注册和保留信息对于医疗保健领导者指导其医疗系统决策非常重要。目前有多种工具可用于理解数据。然而,需要一种多功能工具来更好地汇总数据,为退伍军人事务部领导提供有关退伍军人注册和保留情况的关键信息。
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来源期刊
Health Services Research
Health Services Research 医学-卫生保健
CiteScore
4.80
自引率
5.90%
发文量
193
审稿时长
4-8 weeks
期刊介绍: Health Services Research (HSR) is a peer-reviewed scholarly journal that provides researchers and public and private policymakers with the latest research findings, methods, and concepts related to the financing, organization, delivery, evaluation, and outcomes of health services. Rated as one of the top journals in the fields of health policy and services and health care administration, HSR publishes outstanding articles reporting the findings of original investigations that expand knowledge and understanding of the wide-ranging field of health care and that will help to improve the health of individuals and communities.
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