title: Access to and satisfaction with care comparing patients with and without serious mental illness.
abstract: OBJECTIVE
  We compared perceived access to and satisfaction with health care between patients diagnosed with serious mental illness (SMI: schizophrenia or bipolar disorder) and among those with no SMI diagnosis.
  
  
  METHODS
  We conducted a national, cross-sectional study of VA patients in Fiscal Year (FY) 1999 (N = 7,187) who completed the VA's Large Health Survey of Veteran Enrollees (LHSV) section on access and satisfaction and either received a diagnosis of schizophrenia or bipolar disorder, or did not and were randomly selected from the general non-SMI VA patient population (non-SMI group). We compared the probability of perceived poor access and dissatisfaction using multivariable logistic regression adjusting for patient covariates.
  
  
  RESULTS
  Compared to non-SMI patients, patients diagnosed with bipolar disorder were more likely to report difficulty in receiving care they needed (adjusted OR = 1.36,p < .05) or seeing a specialist (adjusted OR = 1.44, p < .001). Patients diagnosed with schizophrenia were more likely to report dissatisfaction, including thoroughness by their provider (adjusted OR = 1.37, p < .001) and the provider's explanation of problems (adjusted OR = 1.54, p < .001) compared to non-SMI patients.
  
  
  CONCLUSIONS
  Patients diagnosed with bipolar disorder reported greater problems with access to health care, while those diagnosed with schizophrenia were less satisfied with the process of care.
authors.affiliation: VA Pittsburgh Center for Health Equity Research and Promotion, USA. Amy.Kilbourne@gmail.com
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.forename: John F
authors.initials: JF
authors.lastname: McCarthy
authors.forename: Edward P
authors.initials: EP
authors.lastname: Post
authors.forename: Deborah
authors.initials: D
authors.lastname: Welsh
authors.forename: Harold Alan
authors.initials: HA
authors.lastname: Pincus
authors.forename: Mark S
authors.initials: MS
authors.lastname: Bauer
authors.forename: Frederic C
authors.initials: FC
authors.lastname: Blow
mesh_terms: D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D012042:Registries / Q000706:statistics & numerical data; D012044:Regression Analysis; D012559:Schizophrenia / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D014481:United States; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*