title: Changes in veterans' use of outpatient care from 1992 to 2000.
abstract: OBJECTIVE
  During the mid-1990s, the Veterans Health Administration (VHA) reorganized and placed greater emphasis on high-quality primary care. To determine whether the reorganization was associated with changes in patterns of out-patient VHA use, we sought to evaluate changes in characteristics of veterans who use VHA outpatient services between 1992 and 2000.
  
  
  METHODS
  We merged 2 waves of the National Survey of Veterans to determine changes in patterns of outpatient care use. We evaluated the extent to which veterans who received outpatient care received that care from the VHA.
  
  
  RESULTS
  The odds ratio for VHA-only outpatient care relative to non-VHA-only care in 2000 relative to 1992 was 1.75 (95% confidence interval [CI]=1.51, 2.04), and the odds ratio for dual relative to non-VHA-only care was 1.22 (95% CI=1.08, 1.37). Veterans who were older, had low incomes, and had no additional health insurance coverage were most likely to increase their use of VHA outpatient care.
  
  
  CONCLUSIONS
  Our results suggest that the VHA is increasingly serving veterans who have trouble accessing the private health care system.
authors.affiliation: Philadelphia Veterans Affairs Center for Health Equity Research and Promotion, University of Pennsylvania's Leonard Davis Institute of Health Economics, PA 19104-6021, USA. jalong@mail.med.upenn.edu
authors.forename: Judith A
authors.initials: JA
authors.lastname: Long
authors.forename: Daniel
authors.initials: D
authors.lastname: Polsky
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Metlay
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data*; D003625:Data Collection; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D014481:United States; D014728:Veterans