Military veterans are more likely to report delays in seeking necessary health care compared with the U.S. general population, according to a study in the Journal of Public Health Management and Practice.

Such self-reported care delays may be related to having Veterans Administration (VA) health coverage—and to long waiting times in the VA system, according to the study by Doohee Lee, PhD, of Marshall University in South Charleston, West Virginia, and Charles Begley, PhD, of the University of Texas School of Public Health in Houston, Texas. "Access problems within the VA system may be creating disparities in care for this vulnerable and deserving population that need to be mitigated," the researchers write.

Drs. Lee and Begley performed a secondary analysis of data from a nationally representative survey, performed in 2010–2011, to assess delays in seeking health care, in the U.S. population overall and among military veterans in particular. About 11,000 Americans were asked if they had "put off or postponed getting medical care they thought they needed" anytime in the past year.

The results were compared for groups with different types of insurance coverage.  Most respondents had private health insurance; just under 2% were covered by veterans' insurance.

"Those in veterans' care were more likely than the rest of the surveyed population to report care delay," the researchers write. Nearly 29% of veterans reported they had delayed seeking needed medical care, compared with the national rate of 17%.

Reasons for care delays differed among insurance groups. The veterans reported difficulties in making appointments by phone and in getting transportation to the doctor's office (as did Medicare and Medicaid beneficiaries).

After controlling for personal factors and region of the country, veterans were 1.76 times more likely to delay needed medical care compared to privately insured individuals. "Such delays may have an effect on veterans' propensity to seek health care as well, which could be detrimental to their health," according to Drs. Lee and Begley.

The findings are consistent with recently reported problems accessing care within the VA system. Prompted by reports of lengthy wait times in veterans diagnosed with health problems, investigation found manipulation of waiting times and inappropriate scheduling practices at some VA medical centers.

Delays in seeking care are an important issue in the U.S. health care system, working against efforts to improve high-quality, effective health care. Previous studies—mainly comparing patients with public (Medicare and Medicaid) with private insurance—have reported that the type of health insurance coverage affects delays in receiving care.

The new study finds that delays in seeking health care are common in the U.S. population, and that the problem is most pronounced for veterans. Nearly three out of 10 veterans report delays in seeking care over the past year, and there may be a "causal link" with the VA access problems.

Drs. Lee and Begley believe their study has important implications for policies related to reducing care delays—especially among veterans. They conclude, "More studies are needed to expand our understanding on the magnitude and current status of care delay and offer specific steps to rectify related issues on delayed care if reported in military health care."

Source: Wolters Kluwer; May 2, 2016.

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