Journal article
The impact of patient–provider relationships on choosing between VA and VA‐purchased care: A qualitative study of health care decision‐making among rural veterans
The Journal of rural health, Vol.40(3), pp.430-437
11/09/2023
DOI: 10.1111/jrh.12804
PMID: 37942663
Abstract
Abstract Purpose Since the Choice Act in 2014, many Veterans have had greater options for seeking Veteran Affairs (VA)‐purchased care in the community. We investigated factors that influence rural Veterans’ decisions regarding where to seek care. Methods We utilized semi‐structured telephone interviews to query Veterans living in rural or highly rural areas of Midwestern states about their health care options, preferences, and experiences. Interviews were recorded and transcribed, thematically coded, and deductively analyzed using a socioecological approach. Findings Forty rural Veterans (20 men/20 women) ages 28–76 years completed interviews in 2019. We found that rural Veterans often spoke about their relationships and interactions with providers as an important factor in deciding where to seek care. They expressed three socioecological qualities of patient–provider relationships that affected their decisions: (1) personal level—rural Veterans traveled longer distances for more compatible patient–provider relationships; (2) interpersonal level—they sought stable patient–provider relationships that encouraged familiarity, trust, and communication; and (3) organizational level—they emphasized shared identities and expertise that fostered a sense of belonging with their provider. Participants also described how impersonal interactions, status differences, and staff turnover impacted their choice of provider and were disruptive to patient–provider relationships. Conclusions Rural Veterans’ interview responses suggest exploring innovative ways to measure socioecological dimensions (i.e., personal, interpersonal, and organizational) of access‐related decisions and patient–provider relationships to better understand health care barriers and needs. Such measures align with the VA's Whole Health approach that emphasizes person‐centered care and the value of social relationships to Veterans’ health.
Details
- Title: Subtitle
- The impact of patient–provider relationships on choosing between VA and VA‐purchased care: A qualitative study of health care decision‐making among rural veterans
- Creators
- Daniel D. Ball - Iowa City VA Health Care SystemAnne G. Sadler - University of IowaMelissa J. Steffen - Iowa City VA Health Care SystemMonica B. Paez - Iowa City VA Health Care SystemMichelle A. Mengeling - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of rural health, Vol.40(3), pp.430-437
- DOI
- 10.1111/jrh.12804
- PMID
- 37942663
- NLM abbreviation
- J Rural Health
- ISSN
- 0890-765X
- eISSN
- 1748-0361
- Grant note
- DOI: 10.13039/100000738, name: U.S. Department of Veterans Affairs; DOI: 10.13039/100019294, name: Office of Rural Health
- Language
- English
- Electronic publication date
- 11/09/2023
- Academic Unit
- Psychiatry; Injury Prevention Research Center; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984512056402771
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