Ferguson, J. M., Wray, C. M., Jacobs, J., Greene, L., Wagner, T. H., Odden, M. C., Freese, J., Van Campen, J., Asch, S. M., Heyworth, L., & Zulman, D. M. (2023). Variation in initial and continued use of primary, mental health, and specialty video care among veterans. Health Services Research, 58(2), 402-414. https://doi.org/10.1111/1475-6773.14098

https://doi.org/10.1111/1475-6773.14098

Mental health
Veterans

Multiple branches

Veteran

Veteran

Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)

Secondary Analysis
Quantitative Study

Ferguson, Jacqueline M., Wray, Charlie M., Jacobs, Josephine, Greene, Liberty, Wagner, Todd H., Odden, Michelle C., Freese, Jeremy, Van Campen, James, Asch, Steven M., Heyworth, Leonie, Zulman, Donna M.

Objective To identify which Veteran populations are routinely accessing video-based care. Data Sources and Study Setting National, secondary administrative data from electronic health records at the Veterans Health Administration (VHA), 2019-2021 Study Design This retrospective cohort analysis identified patient characteristics associated with the odds of using any video care; and then, among those with a previous video visit, the annual rate of video care utilization. Video care use was reported overall and stratified into care type (e.g., primary, mental health, and specialty video care) between March 10, 2020 and February 28, 2021. Data Collection Veterans active in VA health care (>1 outpatient visit between March 11, 2019 and March 10, 2020) were included in this study. Principal Findings Among 5,389,129 Veterans in this evaluation, approximately 27.4% of Veterans had at least one video visit. We found differences in video care utilization by type of video care: 14.7% of Veterans had at least one primary care video visit, 10.6% a mental health video visit, and 5.9% a specialty care video visit. Veterans with a history of housing instability had a higher overall rate of video care driven by their higher usage of video for mental health care compared with Veterans in stable housing. American Indian/Alaska Native Veterans had reduced odds of video visits, yet similar rates of video care when compared to White Veterans. Low-income Veterans had lower odds of using primary video care yet slightly elevated rates of primary video care among those with at least one video visit when compared to Veterans enrolled at VA without special considerations. Conclusions Variation in video care utilization patterns by type of care identified Veteran populations that might require greater resources and support to initiate and sustain video care use. Our data support service specific outreach to homeless and American Indian/Alaska Native Veterans.

Wiley Online

Article

Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, JMF
Division of Primary Care and Population Health, Stanford University School of Medicine, JMF
Department of Medicine, University of California San Francisco, CMW
Section of Hospital Medicine, Veterans Affairs San Francisco Health Care System, CMW
Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, JJ
Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, LG
Division of Primary Care and Population Health, Stanford University School of Medicine, LG
Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, THW
Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, THW
Geriatric Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, MCO
Department of Epidemiology and Population Health, Stanford University School of Medicine, MCO
Department of Sociology, Stanford University, JF
Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, JVC
Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, SMA
Division of Primary Care and Population Health, Stanford University School of Medicine, SMA
Office of Connected Care/Telehealth, Department of Veterans Affairs Central Office, LH
Department of Medicine, University of California, San Diego School of Medicine, LH
Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, DMZ
Division of Primary Care and Population Health, Stanford University School of Medicine, DMZ