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Perceived Access to General Medical and Psychiatric Care Among Veterans With Bipolar Disorder

Bibliographic Data

ID11036673
AuthorsJohn E Zeber (0000-0002-6606-8847, John E. Zeber and Laurel A. Copeland are with the Veterans Affairs Health Service Research & Development (HSR&D) Center, San Antonio, TX, and the Department of Psychiatry, University of Texas Health Science Center, San Antonio. John F. McCarthy and Amy M. Kilbourne are with the VA Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, and the Department of Psychiatry, University of Michigan, Ann Arbor. Mark S. Bauer is with the VA Medical Center, Providence, RI, and the...), Laurel A Copeland (0000-0002-9478-0209, John E. Zeber and Laurel A. Copeland are with the Veterans Affairs Health Service Research & Development (HSR&D) Center, San Antonio, TX, and the Department of Psychiatry, University of Texas Health Science Center, San Antonio. John F. McCarthy and Amy M. Kilbourne are with the VA Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, and the Department of Psychiatry, University of Michigan, Ann Arbor. Mark S. Bauer is with the VA Medical Center, Providence, RI, and the...), John F Mccarthy (0000-0002-2560-5917, John E. Zeber and Laurel A. Copeland are with the Veterans Affairs Health Service Research & Development (HSR&D) Center, San Antonio, TX, and the Department of Psychiatry, University of Texas Health Science Center, San Antonio. John F. McCarthy and Amy M. Kilbourne are with the VA Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, and the Department of Psychiatry, University of Michigan, Ann Arbor. Mark S. Bauer is with the VA Medical Center, Providence, RI, and the...), Mark S Bauer (0000-0001-6507-9918, John E. Zeber and Laurel A. Copeland are with the Veterans Affairs Health Service Research & Development (HSR&D) Center, San Antonio, TX, and the Department of Psychiatry, University of Texas Health Science Center, San Antonio. John F. McCarthy and Amy M. Kilbourne are with the VA Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, and the Department of Psychiatry, University of Michigan, Ann Arbor. Mark S. Bauer is with the VA Medical Center, Providence, RI, and the...), Amy M Kilbourne (0000-0001-5815-6401, John E. Zeber and Laurel A. Copeland are with the Veterans Affairs Health Service Research & Development (HSR&D) Center, San Antonio, TX, and the Department of Psychiatry, University of Texas Health Science Center, San Antonio. John F. McCarthy and Amy M. Kilbourne are with the VA Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, and the Department of Psychiatry, University of Michigan, Ann Arbor. Mark S. Bauer is with the VA Medical Center, Providence, RI, and the...)
Year2009
Volume99
Issue4
Pages720-727
Publication date2009-04-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2007.131318
PMID19150912
PMCIDPMC2661481
OpenAlexW2030394295
LanguageEN
Citations received4
References cited49

Objectives. We examined associations between patient characteristics and self-reported difficulties in accessing mental health and general medical care services. Methods. Patients were recruited from the Continuous Improvement for Veterans in Care–Mood Disorders study. We used multivariable logistic regression analyses to assess whether predisposing (demographic characteristics), enabling (e.g., homelessness), or need (bipolar symptoms, substance abuse) factors were associated with difficulties in obtaining care, difficulties in locating specialty providers, and forgoing care because of cost. Results. Patients reported greater difficulty in accessing general medical services than in accessing psychiatric care. Individuals experiencing bipolar symptoms more frequently avoided psychiatric care because of cost (odds ratio [OR] = 2.43) and perceived greater difficulties in accessing medical specialists (OR = 2.06). Homeless individuals were more likely to report hospitalization barriers, whereas older and minority patients generally encountered fewer problems accessing treatment. Conclusions. Need and enabling factors were most influential in predicting self-reported difficulties in accessing care, subsequently interfering with treatment dynamics and jeopardizing clinical outcomes. Efforts in the Department of Veterans Affairs to expand mental health care access should be coupled with efforts to ensure adequate access to general medical services among patients with chronic mental illnesses

Bipolar disorder · Family medicine · Health care · Logistic regression · Mental health · Mood · Odds · Odds ratio · Psychiatry · Specialty · Substance abuse · Veterans Affairs · Homelessness and Social Issues · Medicine · Mental Health Treatment and Access · Schizophrenia research and treatment

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Unique citing works4
Citations per year0,27
Citation span2011 - 2022 (12)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 4

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