Access, Quality and Satisfaction with Care: Concerns of Vietnam Veterans

Katherine S. Virgo, Jennette R. Piry, Mary P. Valentine, Darcy R. Denner, Gery Ryan, Nathan K. Risk, Rumi Kato Price

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

The objectives of the current interim report are to measure the extent of the access to care problem, identify and compare the types of patient- and system-based barriers experienced by Vietnam veterans at risk for suicide when seeking care for physical, psychiatric, and substance abuse conditions, analyze patient-perceived quality of care for individuals who obtained access to care, and identify how the care-seeking experience effected future care seeking. This study is based on a longitudinal sample of 494 Vietnam veterans discharged from military service in September 1971 and subsequently identified as at risk for suicide (306 low risk; 188 high risk). Seventy-one percent (350) of 494 participants completed an extensive qualitative and quantitative interview covering, among other topics, physical conditions, psychiatric conditions, substance use, barriers to care, facilitators of care, and quality of care. Barriers, satisfaction, and effect of the experience were compared by type of condition and suicidal risk category using χ2 analysis and Fisher's as appropriate. The analysis is based on 257 interviews (73 percent) with qualitative data transcribed thus far. Results: Of the 195 patients with self-reported health conditions, 76 (39.0 percent) and 45 (23.1 percent) expressed system-based barriers to care, respectively. The group at higher risk of suicide was significantly more likely (p<0.01) to report patient-based barriers to care and system-based barriers to care (p<0.05), and more likely (p<0.05) to experience negative effects of the care-seeking experience. Both self-perceived and system-based barriers to care pose obstacles for patients at high risk of suicide. Targeted interventions are required to reach out to these patients to address needs for care currently unmet by the health care system and to reduce negative effects of the health care experience.

Original languageEnglish
Title of host publicationAccess, Quality and Satisfaction with Care Concerns of Patients, Providers and Insurers
EditorsJennie Kronenfeld
Pages17-40
Number of pages24
DOIs
StatePublished - Nov 3 2006
Externally publishedYes

Publication series

NameResearch in the Sociology of Health Care
Volume24
ISSN (Print)0275-4959

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