Interventions Needed to Improve Wait Times for Veterans Seeking Medical Care

Recent findings suggest policies enacted to improve health care access for veterans are not substantial enough to make a difference.

“Policies and interventions, such as physician relocation incentives, telehealth, or mobile deployment units, may be needed to increase the number of ways patients in underserved areas can interact with the health care system,” said researchers.

Yevgeniy Feyman, BA, Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, and colleagues conducted a cross-sectional study of more than 22 million appointments for approximately 5 million veterans across different geographical regions and found significant variation for appointment wait times.

Using data from the Veterans Health Administration (VHA) Corporate Data Warehouse, included participants had sought medical care between January 1, 2018, and June 30, 202. Primary outcome measures were total appointment wait times (measured in days) in primary care, mental health, and all other specialties. Wait times were aggregated to the Veterans Integrated Services Networks (VISNs)—which is how the VHA organizes medical centers into regions.

The final cohort included 22,632,918 appointments for 4,846,892 veterans, of which 65% were white, 77.3% were male, 80.7% were non-Hispanic, 49.3% were married, and the mean age was 61.6 years.

“Among non-VHA appointments, mean (SD) VISN-level appointment wait times were 38.9 (8.2) days for primary care, 43.9 (9.0) days for mental health, and 41.9 (5.9) days for all other specialties,” compared with “VHA appointments, [for which] mean (SD) VISN-level appointment wait times were 29.0 (5.5) days for primary care, 33.6 (4.6) days for mental health, and 35.4 (2.7) days for all other specialties.”

Authors observed substantial geographic variation in appointment wait times. For example, among the non-VHA appointment group, wait times ranged from 25.4 to 52.4 days for primary care, from 29.3 to 65.7 days for mental health, and from 34.7 to 54.8 days for all other specialties, compared to 22.4 to 43.4 days for primary care, from 24.7 to 42.0 days for mental health, and from 30.3 to 41.9 days for all other specialties in the VHA group.

Authors observed a significant correlation between wait times across the three care categories and region.

“These findings suggest that liberalized access to community care under the Veterans Access, Choice, and Accountability Act and the VA MISSION Act may not result in lower wait times within these regions,” concluded researchers.

Reference:
Feyman Y, Asfaw DA, Griffith KN. Geographic Variation in Appointment Wait Times for US Military Veterans. JAMA Netw Open. 2022;5(8):e2228783. doi:10.1001/jamanetworkopen.2022.28783