{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:43:09Z","timestamp":1783100589385,"version":"3.54.6"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,5,9]],"date-time":"2017-05-09T00:00:00Z","timestamp":1494288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23\u2010AR\u2010064372"],"award-info":[{"award-number":["K23\u2010AR\u2010064372"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Many veterans enrolled in Veterans Affairs (VA) health care systems also receive care through other health care systems. Both VA and non\u2010VA health care use must therefore be considered when conducting research in this population. This study characterized dual\u2010care utilization in veterans with rheumatoid arthritis (RA) and explored associations with RA disease activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Through a questionnaire mailed to RA patients at 3 VA sites, veterans reported medical services by non\u2010VA primary care and subspecialty providers, comorbidities, non\u2010VA medications, and hospitalizations. Disease Activity Score in 28 joints (DAS28) and Multidimensional Health Assessment Questionnaire (MD\u2010HAQ) scores were recorded during VA clinic visits, and respondent groups were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 510 participants surveyed, 318 (62%) responded. Respondents were older (ages 69 versus 66 years; <jats:italic>P<\/jats:italic>\u2009=\u20090.006), more likely nonsmokers (80% versus 67%; <jats:italic>P<\/jats:italic>\u2009=\u20090.001), and had lower disease activity (DAS28 3.3 versus 3.8; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001, MD\u2010HAQ 0.8 versus 0.9; <jats:italic>P<\/jats:italic>\u2009=\u20090.01) than nonrespondents (n\u2009=\u2009192 [38%]). The respondents with a non\u2010VA provider (n\u2009=\u2009130 [41%]) were older (71 versus 68 years; <jats:italic>P<\/jats:italic>\u2009=\u20090.001) and had more education (14 versus 13 years; <jats:italic>P<\/jats:italic>\u2009=\u20090.021) than nondual\u2010care users. Only 6% of respondents reported having a non\u2010VA rheumatologist, with 2% receiving a non\u2010VA prescribed biologic agent or disease\u2010modifying antirheumatic drug.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, VA beneficiaries with RA had lower dual\u2010care utilization than previously reported for the general VA population, with few patients receiving dual rheumatology care or non\u2010VA RA medications. This survey suggests that most US veterans with RA who access VA care use the VA as their primary source of arthritis care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23088","type":"journal-article","created":{"date-parts":[[2016,10,7]],"date-time":"2016-10-07T09:00:28Z","timestamp":1475830828000},"page":"776-782","source":"Crossref","is-referenced-by-count":25,"title":["Utilization of Care Outside the Veterans Affairs Health Care System by US Veterans With Rheumatoid Arthritis"],"prefix":"10.1002","volume":"69","author":[{"given":"Pascale","family":"Schwab","sequence":"first","affiliation":[{"name":"VA Portland Health Care System and Oregon Health and Science University Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harlan","family":"Sayles","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System, and Nebraska Arthritis Outcomes Research Center, University of Nebraska Medical Center 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Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ted R.","family":"Mikuls","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System, and Nebraska Arthritis Outcomes Research Center, University of Nebraska Medical Center Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Barton","sequence":"additional","affiliation":[{"name":"VA Portland Health Care System and Oregon Health and Science University 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