Center for Health Equity Research and Promotion
Assessment of care for Veterans with MHSUDs
CHERP investigators’ study of large sample of Veterans with Mental Health/Substance Abuse Disorders found racial/ethnic differences in their assessment of access, communication, courtesy and comprehensiveness of care. Photo for illustrative purposes only.
Racial and Ethnic Differences in Primary Care Experiences for Veterans with Mental Health and Substance Use Disorders
CHERP investigators Audrey Jones, PhD, Leslie Hausmann, PhD, Adam Gordon, MD, MPH, Maria Mor, PhD and collaborators studied a large sample of Veterans with Mental Health/Substance Abuse Disorders (MH/SUDs) found racial/ethnic differences in their assessment of access, communication, courtesy and comprehensiveness of care.
“Prior studies, conducted before the VA’s transformation to the Patient Aligned Care Team model (PACT), compared patient experiences for those with MHSUDs versus those without,” according to primary author Audrey Jones, PhD. “Our study examines the experiences of Veterans with MHSUDs in the VA’s new model of primary care, and documents racial/ethnic differences among patients with MHSUDs.”
The Journal of General Internal Medicine published an article on this study in June 2016:
Primary care is often the first step in treatment for Veterans with MHSUD. This study examined racial and ethnic differences in positive and negative experiences in VA PCMH settings among Veterans with MHSUDs who completed the VA’s 2013 PCHM Survey of Healthcare Experiences of Patients. This included ratings of access, communication, office staff helpfulness/courtesy, provider ratings, comprehensiveness, medication shared decision-making, and self-management support from 65,930 Veterans with MHSUDs (67% White, 20% Black, 11% Hispanic, 1% American Indian/Alaska Native (AI/AN), and 1% Asian/Pacific Islander (A/PI) ).
FINDINGS:
In this large sample of Veterans with MHSUDs, positive experiences were reported least often for access (22 %). Negative experiences were reported most often for self-management support (30%) and comprehensiveness (16 %), defined as provider attention to MHSU concerns Racial/ethnic differences were observed in all 7 domains. One or more racial/ethnic minority groups reported more negative and/or less positive experiences than Whites in the following 4 domains
Access: Black and Hispanic Veterans reported more negative and fewer positive experiences than White Veterans. AI/AN Veterans also reported more negative experiences
Communication: AI/AN and A/PI Veterans reported more negative and/or fewer positive experiences than White Veterans. Black Veterans reported fewer negative experiences.
Office Staff Helpfulness/Courtesy: Hispanic Veterans reported fewer positive experiences than White Veterans. AI/ANs and A/PIs reported more negative experiences.
Comprehensiveness: Hispanic Veterans reported more negative experiences than White Veterans, while Black Veterans reported more positive experiences.
"Next steps include developing interventions to improve access experiences for Veterans with MHSUDs," writes Dr. Jones. "One potential strategy could employ peer navigators to assist Veterans with MHSUDs in scheduling appointments and navigating VHA to receive timely care."
The contents of this article do not necessarily represent the views of the US government or the Department of Veterans Affairs.
