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Access to Care Among Nonelderly Veterans

Bernard, Didem M. PhD; Selden, Thomas M. PhD

doi: 10.1097/MLR.0000000000000508
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Background: Veteran access to care is an important policy issue that has not previously been examined with population-based survey data.

Objectives: This study compares access to care for nonelderly adult Veterans versus comparable non-Veterans, overall and within subgroups defined by simulated eligibility for health care from the Veterans Health Administration and by insurance status.

Research Design: We use household survey data from the Medical Expenditure Panel Survey from 2006 to 2011. We use iterative proportional fitting to standardize (control for) differences in age, sex, income, medical conditions, disability, Census region, and Metropolitan Statistical Area.

Subjects: Nonelderly Veterans and comparable non-Veterans.

Measures: For medical, dental, and prescription medicine treatments, we use 4 access measures: delaying care, inability to obtain care, perceiving delay as a big problem, and perceiving inability to obtain care as a big problem. We also examine having a usual source of care.

Results: Frequencies of access barriers are similar for nonelderly Veterans and comparable non-Veterans for dental and prescription medicine treatments. For medical treatment, we find that Veterans eligible for VA health care and Veterans with VA use who are uninsured report fewer access problems than the comparable non-Veteran populations for 2 measures: inability to obtain care and reporting inability to obtain care as a big problem.

Conclusions: Our results show that uninsured Veterans, the most policy-relevant group, have better access to care than comparable non-Veterans. Our results highlight the importance of adjusting Veteran and non-Veteran comparisons to account for the higher than average health care needs of Veterans.

Supplemental Digital Content is available in the text.

Center for Financing, Access, and Cost Trends, Division of Modeling and Research, Agency for Healthcare Research and Quality (AHRQ), Rockville, MD

Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website, www.lww-medicalcare.com.

The views expressed in this article are those of the authors, and no official endorsement by the US Department of Health and Human Services or the AHRQ is intended or should be inferred.

The authors declare no conflict of interest.

Reprints: Didem Bernard, PhD, Center for Financing, Access, and Cost Trends, Division of Modeling and Research, Agency for Healthcare Research and Quality (AHRQ), 540 Gaither Road, Rockville, MD 20850. E-mail: didem.bernard@ahrq.hhs.gov.

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