title: Racial variations in Department of Veterans Affairs ambulatory care use and unmet health care needs.
abstract: Our objective was to describe racial/ethnic variations in Department of Veterans Affairs (VA) ambulatory care use and its association with the presence of unmet health care needs. Using the 1992 National Survey of Veterans, we examined race/ethnicity and unmet health care need for ambulatory care users of VA and non-VA facilities. Black and Hispanic veterans were more likely to report any VA use. In unadjusted analyses, American Indian/Eskimo, Hispanic, and black veterans were 4.4, 2.5, and 1.9 times more likely, respectively, than white veterans to report an inability to get needed care. Adjusting for VA ambulatory care use diminished the disparity in inability to get needed care between American Indian/Eskimo or Hispanic veterans and white veterans and eliminated the disparity between black and white veterans. Our findings support the VA's role as a medical safety net provider and suggest that VA ambulatory care use is effective in mitigating health-related racial disparities for some veterans. Additional facilitators for reducing unmet need should be explored.
authors.affiliation: Department of Medicine, VA Greater Los Angeles Healthcare System, School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. donna.washington@med.va.gov
authors.forename: Donna L
authors.initials: DL
authors.lastname: Washington
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Harada
authors.forename: Valentine M
authors.initials: VM
authors.lastname: Villa
authors.forename: JoAnn
authors.initials: J
authors.lastname: Damron-Rodriguez
authors.forename: Shawkat
authors.initials: S
authors.lastname: Dhanani
authors.forename: Herb
authors.initials: H
authors.lastname: Shon
authors.forename: Takashi
authors.initials: T
authors.lastname: Makinodan
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008913:Minority Groups / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000145:classification* / Q000706:statistics & numerical data