The receipt of prevention services by veterans using VA versus non-VA facilities

Objectives. This paper compares the health promotion/disease prevention services received by veterans who reported receiving 90%+ of their care inside Veterans Health Administration (VA) facilities with counterparts who reported receiving 90%+ of their care outside VA facilities. Results are compared with the U.S. Healthy People 2000 goals. Methods. Random samples were drawn of 300 men and 150 women visiting primary care clinics in six VA facilities. A 66% adjusted response rate was achieved after two mailings (n = 1,703). For this analysis, those veterans who reported receiving 90%+ of their care inside VA facilities (n = 909) were compared with veterans who reported receiving 90%+ of their care outside VA facilities (n = 185). Results. Of the 13 health promotion/disease prevention services, 6 were significantly influenced by source of care. Five of the significant differences reflected statistically higher prevalence rates for those receiving 90%+ of their care inside the VA (mammograms and counseling for alcohol, nutrition, exercise, and seatbelt use). One reflected a higher prevalence rate for those receiving 90%+ of their care outside the VA system (tetanus boosters). Conclusions. Veterans receiving 90%+ of their care in VA facilities obtained more preventive services than counterparts using non-VA providers. Assessment and counseling services need to be targeted to more veterans to comply more fully with U.S. Preventive Services Task Force recommendations and Healthy People 2000 objectives. (C) 1998 American Health Foundation and Academic Press.