title: The effect of distance to VA facilities on the choice and level of utilization of VA outpatient services.
abstract: The 1987 survey of Veterans is used to explain the effects of distance to VA facilities on the choice and level of utilization of VA outpatient services by U.S. veterans. A two part discrete/continuous model is used to separate two elements of the decision to seek outpatient services from federally operated VA facilities. First, a discrete choice is made to seek care from the VA. Second, a continuous choice is made to seek a particular level of utilization. Distance is found to affect the initial discrete choice significantly for measured distances up to 60 miles at a decreasing rate. Once some VA outpatient contact is made, distance is a major factor only for the elderly in determining the amount of utilization. Disturbingly, elderly veteran users living more than 30-40 miles from the nearest VA are expected to make fewer visits in a year than younger veterans.
authors.affiliation: Department of Veterans Affairs, Bedford, MA 01730.
authors.forename: J F
authors.initials: JF
authors.lastname: Burgess
authors.forename: D A
authors.initials: DA
authors.lastname: DeFiore
mesh_terms: D000368:Aged; D006302:Health Services Research; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D008507:Medically Underserved Area; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D012044:Regression Analysis; D014481:United States; D014728:Veterans / Q000523:psychology