Affiliation:
1. VA Salt Lake City Health Care System Informatics, Decision‐Enhancement and Analytic Sciences Center (IDEAS) Salt Lake City Utah USA
2. University of Utah School of Medicine Salt Lake City Utah USA
3. VA Palo Alto Health Care System Center for Innovation to Implementation (Ci2i) Menlo Park California USA
4. Stanford University School of Medicine VA Palo Alto Health Care System Menlo Park California USA
Abstract
AbstractObjectiveTo understand Veterans Health Administration (VA) leaders' information and resource needs for managing post‐9/11 Veterans' VA enrollment and retention.Data Sources and Study SettingInterviews 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 DesignInterview 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 MethodsTwo coders analyzed 22% (N = 6) of the interviews and discussed and adjudicated any discrepancies. One coder independently coded the remainder of the interviews.Principal FindingsSeveral 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.ConclusionsEnrollment 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.
Funder
Institute of Development and Economic Alternatives
Health Services Research and Development
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