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. 2023 Apr;58(2):402-414.
doi: 10.1111/1475-6773.14098. Epub 2022 Nov 24.

Variation in initial and continued use of primary, mental health, and specialty video care among Veterans

Jacqueline M Ferguson  1   2 , Charlie M Wray  3   4 , Josephine Jacobs  5 , Liberty Greene  1   2 , Todd H Wagner  1   5 , Michelle C Odden  6   7 , Jeremy Freese  8 , James Van Campen  1 , Steven M Asch  1   2 , Leonie Heyworth  9   10 , Donna M Zulman  1   2
Affiliations

Variation in initial and continued use of primary, mental health, and specialty video care among Veterans

Jacqueline M Ferguson et al. Health Serv Res. 2023 Apr.

Abstract

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.

Keywords: COVID-19; Veterans; access to care; delivery of health care; disparities; telemedicine.

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References

    1. Heyworth L, Kirsh S, Zulman D, Ferguson JM, Kizer KW. Expanding access through virtual Care: the VA's early experience with Covid‐19. NEJM Catal Innov Care Deliv. 2020;1(4):1‐11. doi:10.1056/CAT.20.0327 - DOI
    1. Koonin LM, Hoots B, Tsang CA, et al. Trends in the use of telehealth during the emergence of the COVID‐19 pandemic — United States, January–March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(43):1595‐1599. doi:10.15585/mmwr.mm6943a3 - DOI - PMC - PubMed
    1. Connolly SL, Stolzmann KL, Heyworth L, Weaver KR, Bauer MS, Miller CJ. Rapid increase in Telemental health within the Department of Veterans Affairs during the COVID‐19 pandemic. Telemed e‐Health. 2020;27(4):454‐458. doi:10.1089/tmj.2020.0233 - DOI - PubMed
    1. Reddy A, Gunnink E, Deeds SA, et al. A rapid mobilization of ‘virtual’ primary care services in response to COVID‐19 at Veterans Health Administration. Healthcare. 2020;8(4):18‐20. doi:10.1016/j.hjdsi.2020.100464 - DOI - PMC - PubMed
    1. Harju A, Neufeld J. Telehealth utilization during the COVID‐19 pandemic: a preliminary selective review. Telemed Rep. 2022;3(1):38‐47. doi:10.1089/tmr.2021.0040 - DOI - PMC - PubMed

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