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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.

(Published 2023. This article is a U.S. Government work and is in the public domain in the USA.)

Titel:	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.
Autor/in / Beteiligte Person:	Ball, DD ; Sadler, AG ; Steffen, MJ ; Paez, MB ; Mengeling, MA
Link:	Full Text Finder (Volltext)
Zeitschrift:	The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, Jg. 40 (2024-06-01), Heft 3, S. 430-437
Veröffentlichung:	[Oxford, Eng.] : Blackwell ; <i>Original Publication</i>: [Burlington, Vt.?] : Journal of Rural Health, c1985-, 2024
Medientyp:	academicJournal
ISSN:	1748-0361 (electronic)
DOI:	10.1111/jrh.12804
Schlagwort:	Humans Middle Aged Male Female Adult Aged United States Interviews as Topic methods Veterans psychology Veterans statistics & numerical data Qualitative Research Rural Population statistics & numerical data Decision Making United States Department of Veterans Affairs organization & administration United States Department of Veterans Affairs statistics & numerical data
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [J Rural Health] 2024 Jun; Vol. 40 (3), pp. 430-437. <i>Date of Electronic Publication: </i>2023 Nov 09. MeSH Terms: Veterans* / psychology ; Veterans* / statistics & numerical data ; Qualitative Research* ; Rural Population* / statistics & numerical data ; Decision Making* ; United States Department of Veterans Affairs* / organization & administration ; United States Department of Veterans Affairs* / statistics & numerical data ; Humans ; Middle Aged ; Male ; Female ; Adult ; Aged ; United States ; Interviews as Topic / methods References: Congressional Budget Office. The Veterans Community Care Program: Background and Early Effects. Congressional Budget Office; 2021. Accessed March 15, 2021. https://www.cbo.gov/publication/57257. ; Buzza C, Ono SS, Turvey C, et al. Distance is relative: unpacking a principal barrier in rural healthcare. 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Grant Information: U.S. Department of Veterans Affairs; Office of Rural Health Contributed Indexing: Keywords: access to care; health care decision‐making; patient–provider relationships; quality of care; rural veterans Entry Date(s): Date Created: 20231109 Date Completed: 20240619 Latest Revision: 20240619 Update Code: 20240619

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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.