0406 Demographic Factors Are Unrelated to Interest in VA BSM Services: Results of a Quality Improvement Initiative

Abstract Introduction High rates of sleep disorders in Veterans increases demand for behavioral sleep medicine (BSM) services and clinical efficiency is essential to improving access to care. An ongoing quality improvement project assessing the utility of a clinic orientation group reduced intake no-show rates within a large Department of Veterans Affairs (VA) BSM clinic and revealed that some Veterans declined services after learning more about the treatment offerings. The goal of this analysis was to identify characteristics of patients following completion of the orientation group that predicted acceptance of BSM services to address potential disparities in engagement with BSM. Methods Data from 228 Veterans referred for BSM services were analyzed. Individuals were coded as interested (scheduling or attending intake) vs. disinterested (declining or failing to attend intake) in BSM. Predictors included 1) race (0=white, 1=BIPOC), 2) Age, and 3) medical complexity based on VA disability rating and care assessment need (CAN) score (score predicting risk of hospitalization within the next year). Results Of the 228 Veterans reviewed, most patients were male (n =183, 84%) and identified as white (n=73; 32%), followed by Hispanic/Latinx (n=48, 21%), and Black (n=44, 19.3%) race/ethnicity. Average age was 51.4 years; SD=15.23, range [22,95]). A total of 73% (n=166) were interested in BSM services after the orientation group and 27% (n=62) were disinterested. Chi-square and logistic regression results indicated no differences between groups across predictors explored (p-values 0.34-0.80) when evaluated individually or in a multivariable model. No-show to intake appointments fell from 21% (n=74 out of 353 in the 11 months prior to initiation of the orientation group to 7.5% (17/267) after the orientation group was initiated. Conclusion Over one quarter of veterans referred to a BSM orientation group declined BSM services after learning more about services offered. Reduced intake no-shows suggests improved clinic efficiency. We did not identify differences in acceptance of services based on race/ethnicity, age, or medical complexity. Although the number of women in this sample was too small for statistical analysis, gender differences should be evaluated with a larger sample. Additional evaluations will consider whether disparities exist elsewhere in the referral pathway. Support (if any) VAGLAHS GRECC