Titre :
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Is travel distance a barrier to veterans'use of VA hospitals for medical surgical care. (2000)
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Auteurs :
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C. MOONEY ;
C.S. PHIBBS ;
S. SCHMITT ;
J. ZWANZIGER ;
Department of Community and Preventive Medicine. University of Rochester. Rochester. NY. USA ;
Department of Health. Research and Policy at Stanford University. Stanford. USA ;
Health Economics Resource Center and Cooperative Studies Program. Center for Health Care Evaluation. Veterans Health Administration. Palo Alto Health Care System. Palo Alto. USA
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Type de document :
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Article
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Dans :
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Social science and medicine (vol. 50, n° 12, 2000)
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Pagination :
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1743-1755
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Langues:
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Anglais
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Mots-clés :
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Hospitalisation
;
Taux
;
Distance
;
Evaluation
;
Homme
;
Etats Unis
;
Amérique
;
Amérique du Nord
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Résumé :
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[BDSP. Notice produite par INIST GgW84R0x. Diffusion soumise à autorisation]. Lengthy travel distances may explain why relatively few veterans in the United States use VA hospitals for inpatient medical/surgical care. We used two approaches to distinguish the effect of distance on VA use from other factors such as access to alternatives and veterans'characteristics. The first approach describes how disparities in travel distance to the VA are related to other characteristics of geographic areas. The second approach involved a multivariate analysis of VA use in postal zip code areas (ZCAs). We used several sources of data to estimate the number of veterans who had priority access to the VA so that use rates could be estimated. Access to hospitals was characterized by estimated travel distance to inpatient providers that typically serve each ZCA. The results demonstrate that travel distance to the VA is variable, with veterans in rural areas traveling much farther for VA care than veterans in areas of high population density. However, Medicare recipients also travel farther in areas of low population density. In some areas veterans must travel lengthy distances for VA care because VA hospitals which were built over the past few decades are not located close to areas in which veterans reside in the 1990s. The disparities in travel distance suggest inequitable access to the VA. Use of the VA decreases with increases in travel distance only up to about 15 miles, after which use is relatively insensitive to further increases in distance. (...)
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