{"id":335,"date":"2014-06-03T15:27:37","date_gmt":"2014-06-03T15:27:37","guid":{"rendered":"http:\/\/thesocietypages.org\/trot\/?p=335"},"modified":"2015-10-13T19:06:18","modified_gmt":"2015-10-13T19:06:18","slug":"waitlists-and-worse-rebuilding-va-health-care","status":"publish","type":"post","link":"https:\/\/thesocietypages.org\/trot\/2014\/06\/03\/waitlists-and-worse-rebuilding-va-health-care\/","title":{"rendered":"Waitlists and Worse: Rebuilding VA Health Care"},"content":{"rendered":"<p><a href=\"http:\/\/www.cnn.com\/2014\/05\/30\/politics\/va-hospitals-shinseki\/\">Eric Shinseki resigned<\/a>\u00a0last Friday as head of the Department of Veterans Affairs, stating that \u201cthe VA needs new leadership\u201d. This comes in the wake of\u00a0scheduling issues at VA medical centers\u00a0leading to\u00a0extended delays for veterans&#8217; healthcare\u2014issues he now recognizes as a \u201csystemic lack of integrity\u201d involving a widespread cover-up. According to\u00a0a <a href=\"http:\/\/www.cnn.com\/interactive\/2014\/05\/politics\/document-va-audit\/?iid=article_sidebar\">new VA audit report<\/a> prompted by a series of <a href=\"http:\/\/www.cnn.com\/2013\/11\/19\/health\/veterans-dying-health-care-delays\/index.html?iid=article_sidebar\">CNN investigations<\/a>,\u00a0<a href=\"http:\/\/www.cnn.com\/2014\/04\/23\/health\/veterans-dying-health-care-delays\/\">deadly delays<\/a>\u00a0in care were being suppressed by clinics driven to meet performance targets. The VA report concluded that the 14-day wait time performance target was \u201csimply not attainable,\u201d and it called for a \u201clong-term, comprehensive reset\u201d of the broken system. While \u00a0Shinseki acknowledges these problems, how reasonable is it to expect his successor to fix them? Research shows that scheduling issues are only one barrier among many to veterans\u2019 accessing care.<\/p>\n<h5>When predicting which people will seek care, sociologists take into account patients&#8217;\u00a0prior experiences with the system such as health outcomes and customer satisfaction.\u00a0Poor service doesn&#8217;t just hurt the veterans who seek care\u2014it may keep them from seeking care in the first place!<\/h5>\n<ul>\n<li><a href=\"http:\/\/www.sociology.ucla.edu\/professors\/RONALD%20M%20ANDERSEN\/?id=21\">Ronald M. Andersen<\/a>, 1995. \u00a0<a href=\"http:\/\/globalhealth.stanford.edu\/resources\/Revisiting_Behavioral_Model_and_Access.pdf\">&#8220;Revisiting the behavioral model and access to medical care: does it matter?.&#8221; <\/a><i>Journal of health and social behavior<\/i> 36(1): 1-10.<\/li>\n<\/ul>\n<h5>Some veterans are eligible for both Medicaid and VA services. The largest group of these vets relies on\u00a0Medicaid rather than VA care or\u00a0a combination of the two.<\/h5>\n<ul>\n<li><a href=\"http:\/\/www.medicine.uic.edu\/cms\/One.aspx?portalId=506244&amp;pageId=4952969\">Denise M. Hynes<\/a>, Kristin Koelling, <a href=\"http:\/\/www.herc.research.va.gov\/training\/training_presenter_details.asp?id=Stroupe,%20K\">Kevin Stroupe<\/a>, et al. 2007. <a href=\"http:\/\/journals.lww.com\/lww-medicalcare\/Abstract\/2007\/03000\/Veterans__Access_to_and_Use_of_Medicare_and.5.aspx\">Veterans&#8217; access to and use of Medicare and Veterans Affairs health care<\/a>. <i>Medical care<\/i>, <i>45<\/i>(3): 214-223.<\/li>\n<\/ul>\n<h5>Issues with gender in the military also have an effect. Female veterans have less access to\u00a0VA healthcare relative to males, with 19% of women reporting delayed health care or unmet needs. Knowledge gaps about VA care, perceptions that providers are not gender-sensitive, and a history of military sexual assault predicted women\u2019s likelihood to delay or forgo treatment.<\/h5>\n<ul>\n<li><a href=\"http:\/\/www.researchgate.net\/profile\/Donna_Washington\">Donna L. Washington<\/a>, <a href=\"http:\/\/www.va.gov\/providerinfo\/losangeles\/detail.asp?providerid=3054\">Bevanne Bean-Mayberry<\/a>, <a href=\"http:\/\/www.researchgate.net\/profile\/Deborah_Riopelle\">Deborah Riopelle<\/a>, and <a href=\"http:\/\/hpm.ph.ucla.edu\/elizabeth-yano\">Elizabeth M. Yano<\/a>. 2011. <a href=\"http:\/\/link.springer.com\/article\/10.1007\/s11606-011-1772-z\">&#8220;Access to care for women veterans: delayed healthcare and unmet need.&#8221;<\/a><i>Journal of general internal medicine<\/i> 26(2): 655-661.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><script src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\" async=\"\"><\/script><!-- TSP testing --> <ins class=\"adsbygoogle\" style=\"display: inline-block; width: 234px; height: 60px;\" data-ad-client=\"ca-pub-4670099812817063\" data-ad-slot=\"1069646635\"><\/ins><script>\/\/ <![CDATA[\n(adsbygoogle = window.adsbygoogle || []).push({});\n\/\/ ]]><\/script><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Eric Shinseki resigned\u00a0last Friday as head of the Department of Veterans Affairs, stating that \u201cthe VA needs new leadership\u201d. This comes in the wake of\u00a0scheduling issues at VA medical centers\u00a0leading to\u00a0extended delays for veterans&#8217; healthcare\u2014issues he now recognizes as a \u201csystemic lack of integrity\u201d involving a widespread cover-up. According to\u00a0a new VA audit report prompted [&hellip;]<\/p>\n","protected":false},"author":1952,"featured_media":568,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[55,33,13,85],"tags":[38545,355,38541,38546,4071],"class_list":["post-335","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-gender","category-health","category-inequality","category-politics","tag-gender","tag-government","tag-inequality","tag-politics","tag-public-health"],"jetpack_featured_media_url":"https:\/\/thesocietypages.org\/trot\/files\/2014\/06\/3387341859_11c6054226_z.jpg","_links":{"self":[{"href":"https:\/\/thesocietypages.org\/trot\/wp-json\/wp\/v2\/posts\/335","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/thesocietypages.org\/trot\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thesocietypages.org\/trot\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thesocietypages.org\/trot\/wp-json\/wp\/v2\/users\/1952"}],"replies":[{"embeddable":true,"href":"https:\/\/thesocietypages.org\/trot\/wp-json\/wp\/v2\/comments?post=335"}],"version-history":[{"count":3,"href":"https:\/\/thesocietypages.org\/trot\/wp-json\/wp\/v2\/posts\/335\/revisions"}],"predecessor-version":[{"id":569,"href":"https:\/\/thesocietypages.org\/trot\/wp-json\/wp\/v2\/posts\/335\/revisions\/569"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/thesocietypages.org\/trot\/wp-json\/wp\/v2\/media\/568"}],"wp:attachment":[{"href":"https:\/\/thesocietypages.org\/trot\/wp-json\/wp\/v2\/media?parent=335"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thesocietypages.org\/trot\/wp-json\/wp\/v2\/categories?post=335"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thesocietypages.org\/trot\/wp-json\/wp\/v2\/tags?post=335"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}