Drivers of Veterans' Healthcare Choices and Experiences with Veterans Affairs and Civilian Healthcare

Background: Access to quality healthcare is essential to the well-being of U.S. veterans. Little is known about what drives veterans' healthcare decisions. The purpose of this study was to explore factors that drive healthcare choices in veterans, and their experiences in the Veterans Health Administration (VA) and non-VA healthcare settings. Methods: Fifty-nine veterans participated in eight focus groups. Participants were asked to discuss factors that led to their choice of provider and their healthcare experiences. Thematic analysis was conducted to reveal themes around healthcare choices and use. Results: VA and non-VA users described positive experiences with care. VA users reported cost, quality, and ease of care as reasons for use. Non-VA healthcare setting users reported eligibility issues, negative perceptions of the VA, administrative bureaucracy, and lack of continuity of care as reasons they chose not to use VA care. VA users reported difficulty with red tape, continuity of care, limitations to gender specific care, and having to advocate for themselves. Conclusions: Veterans were satisfied with care regardless of where they received it. Experiences with civilian providers indicate that more could be done to provide veterans with choices in the care they receive. Despite positive experiences with the VA, the veterans highlighted needed improvements in key areas.