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Psychiatr Serv. 2010 Oct;61(10):1035-8. doi: 10.1176/ps.2010.61.10.1035.

Access-related measures and out-of-system utilization among veterans with bipolar disorder.

Author information

1
U.S. Department of Veterans Affairs National Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, MI 48113-0170, USA. john.mccarthy2@va.gov

Abstract

OBJECTIVE:

This study examined associations between access-related measures and out-of-system health services utilization (general medicine and mental health services) among patients with bipolar disorder at a U.S. Department of Veterans Affairs (VA) medical center.

METHODS:

VA patients (N=391) with bipolar disorder answered questions about health services access (non-VA insurance coverage, travel distance to their VA facility, service-connected disability status, and difficulty receiving needed mental health care) and out-of-system services utilization. Multivariable Tobit regression was used to evaluate associations between access measures and propensity to receive out-of-system services.

RESULTS:

More than half the veterans (56%) reported some non-VA utilization. Out-of-system utilization was more likely among patients who were married, younger, homeless, with private insurance, without service-connected disabilities, and who reported access difficulties.

CONCLUSIONS:

Out-of-system utilization was associated with multiple measures of access and indicators specific to VA and non-VA providers. Enhancing health system access for patients with bipolar disorder may reduce out-of-system utilization, potentially enhancing continuity of care.

PMID:
20889645
DOI:
10.1176/ps.2010.61.10.1035
[Indexed for MEDLINE]

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