Disabilities among veterans and their utilization of health care

摘要

Objectives : This study introduces a conceptual model to investigate factors that influence healthcare utilization. The model included three components: Need for Care, Facilitators and Barriers of Access, and Health Care Utilization. Methods : A nationally representative sample of 13,244 male veterans aged 18 and older was extracted from the 2011 National Health Interview Survey. The sample included 2890 veterans with disabilities. Descriptive analyses and multiple logistic regression analyses were performed, along with significance tests for differences in distributions. Results : Need for services was operationalized by perceived health and number of types of disabilities. Both these variables, predicted healthcare utilization, making visits to the emergency room and staying in the hospital overnight. Facilitators and barriers were operationalized as political structures, societal structure, and demographic variables partially contributed to the model. The political variables, which wars the veterans fought, predicted utilization, but the societal variable, poverty, did not. There were no differences between African-Americans and Caucasians in utilization of health care. Differences did emerge based on region of domicile, marital status, and age. Conclusion : The conceptual model introduced in this paper does not support the notion that healthcare utilization is predicted by poverty. It may be that governmental insurance provides a safety net that insures access to acute medical care. Utilization also appears to be predicted by access to care, from regional resources and social support. Future research should tease apart reasons why regional differences emerge and inform policy-makers who appropriate funds for establishment of healthcare centers.