Getting the medical care you need quickly is important, and understanding where to go and what to expect can help. The Veterans Health Administration (VHA) wait times were lower than those of community doctors in many areas, even after accounting for differences in the mix of specialties. This standardization ensures that any estimated difference in waiting times at the Visn level is not due to differences in the combination of specialties. VHA outperformed community care in terms of wait times for most ViSNs; these results suggest that policies to liberalize veterans' access to private sector doctors may not reduce waiting times in those regions.
Among VHA appointments, the correlation coefficients were r %3D 0.29 for primary care and other specialties, r %3D 0.58 for mental health and other specialties, and r %3D 0.16 for primary care and mental health. When seeking medical care in the community, veterans waited an average (SD) of 34.8 (41) days for primary care, 40.4 (42) days for mental health care, and 40.6 (4.2) days for other specialties. There was a similar variation in waiting times for approval of appointments to see a doctor (table 2 of the supplement). This ranged from a low of 24.7 (23.7 days) in VISN 12, which covers Wisconsin and Illinois, to a high of 42.0 (3.7 days) in VISN 6, which covers Virginia and North Carolina (chart 3 and electronic figure 3 of the supplement).
Wait times for approval were 2.0 (11, days in total) and ranged from a minimum of 1.3 (7, days) on VISN 16, which covers Arkansas, Mississippi and Louisiana, and a maximum of 3.0 (1.1, days) on VISN 2.0, which covers Washington, Oregon, Idaho and Alaska. These findings suggest that liberalized access to community care under the Veterans Access, Choice and Accountability Act and the VA MISSION Act may not result in lower wait times in these regions. Table 3 of the supplement provides additional descriptive statistics, including median wait times and approval times. Additional descriptive statistics, including average wait times and approval times, are available in Table 5 of the supplement.
However, to date, there is limited evidence on geographical variation in veterans' waiting times for community care, or on how these wait times compare with those at VHA medical centers. This cross-sectional study revealed substantial variation in waiting times by type of care and geographical region, and waiting times for HAV in most VISNs were lower than those of community doctors, even after accounting for differences in the combination of specialties.
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