A Triangulated Qualitative Study of Veteran Decision-Making to Seek Care During Heart Failure Exacerbation
Implications of Dual Health System Use
Bibliographic Data
| ID | 13775800 |
|---|---|
| Authors | Charlene Pope (0000-0002-9761-9007, Medical University of South Carolina), Charlene A Pope (Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA), Boyd H Davis (0000-0003-4773-7715, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA), Leticia Wine (Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA), Lynne S Nemeth (0000-0001-8691-1400, Medical University of South Carolina, Charleston, USA), R Neal Axon (0000-0001-8821-7295, Ralph H. Johnson VA Medical Center, corresponding author) |
| Year | 2018 |
| Volume | 55 |
| Pages | 46958017751506-46958017751506 |
| Publication date | 2018-01-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | INQUIRY The Journal of Health Care Organization Provision and Financing (JOURNAL) |
| Journal identifiers | ISSN: 0046-9580 • E-ISSN: 1945-7243 |
| Publisher | SAGE Publishing (PUBLISHER • US) |
| DOI | 10.1177/0046958017751506 |
| PMID | 29482411 |
| OpenAlex | W2789089503 |
| Language | EN |
| References cited | 36 |
Among Veterans, heart failure (HF) contributes to frequent emergency department visits and hospitalization. Dual health care system use (dual use) occurs when Veterans Health Administration (VA) enrollees also receive care from non-VA sources. Mounting evidence suggests that dual use decreases efficiency and patient safety. This qualitative study used constructivist grounded theory and content analysis to examine decision making among 25 Veterans with HF, for similarities and differences between all-VA users and dual users. In general, all-VA users praised specific VA providers, called services helpful, and expressed positive capacity for managing HF. In addition, several Veterans who described inadvertent one-time non-VA health care utilization in emergent situations more closely mirrored all-VA users. By contrast, committed dual users more often reported unmet needs, nonresponse to VA requests, and faster services in non-VA facilities. However, a primary trigger for dual use was VA telephone referral for escalating symptoms, instead of care coordination or primary/specialty care problem-solving
Dual (grammatical number · Emergency department · Exacerbation · Family medicine · Health care · Medical emergency · Qualitative research · Referral · Specialty · Veterans Affairs · Emergency and Acute Care Studies · Healthcare Policy and Management · Heart Failure Treatment and Management · Medicine · Nursing
Qualitative interviewing
Content analysis
Qualitative Content Analysis in Practice
Forecasting the Future of Cardiovascular Disease in the United States
Heart Disease and Stroke Statistics—2015 Update
Veterans Health Administration and Medicare Outpatient Health Care Utilization by Older Rural and Urban New England Veterans
Using Grounded Theory as a Method of Inquiry
Is Same-Hospital Readmission Rate a Good Surrogate for All-Hospital Readmission Rate
Comparing the Characteristics, Utilization, Efficiency, and Outcomes of VA and Non-VA Inpatient Care Provided to VA Enrollees
From key words to key semantic domains
Qualitative Data Analysis for Health Services Research
A story of maladies, misconceptions and mishaps
| Highly cited | No |
|---|