The impact of trust, satisfaction, and perceived quality on preference for setting of future care among veterans with PTSD

Elizabeth Haro, Michael Mader, Polly H Noel, Hector Garcia, Dawne Vogt, Nancy Bernardy, Mary Bollinger, Mary J Pugh, Erin P. Finley

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Introduction: Among US veterans, posttraumatic stress disorder (PTSD) is a high-prevalence condition;more than a million veterans of all combat eras are service-connected for this condition. Research on factors drivingveterans' decision-making regarding preferred setting for PTSD care has been limited. The purpose of this study wasto understand factors associated with preferences for setting of future PTSD care among veterans service-connected forPTSD. Materials and Methods: We conducted a cross-sectional mailed survey among veterans with service connectionfor PTSD in Texas and Vermont identified from the Veterans Services Network Corporate Mini Master File(VETSNET). Survey items were intended to elucidate PTSD healthcare decision-making and queried utilization,perceived need for care, and satisfaction and preferences for VA, community, and/or military setting for receipt offuture PTSD care. Logistic regression was used to identify factors associated with preference for care setting. UTHealth San Antonio's Institutional Review Board determined this quality improvement project to be non-research.Results: Veterans (n = 2,327) were surveyed with an overall response rate of 37.1%. Most veterans (72.4%) identifiedVA as a preferred site for their future PTSD care; a substantial, but smaller, number of veterans identified being interested in receiving care in community (39.9%) and military (12.7%) settings. Factors associated with preferences forfuture care setting included demographics (e.g., ethnicity, income), availability of healthcare coverage, prior experiences of care, and attitudes related to perceived quality of care and trust in VA. Conclusions: These findings suggestthat it is important to retain foundational mental health services within VA, as well as to continue to invest in buildingprovider and network capacity in community settings, to ensure alignment with veteran preferences for care setting.

Original languageEnglish (US)
Pages (from-to)e708-e714
JournalMilitary medicine
Issue number11-12
StatePublished - Nov 1 2019

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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