The 1987 survey of Veterans is used to explain the effects of distance to VA facilities on the choice and level of utilization of VA outpatient services by U.S. veterans.

A two part discrete/continuous model is used to separate two elements of the decision to seek outpatient services from federally operated VA facilities.

First, a discrete choice is made to seek care from the VA.

Second, a continuous choice is made to seek a particular level of utilization.

Distance is found to affect the initial discrete choice significantly for measured distances up to 60 miles at a decreasing rate.

Once some VA outpatient contact is made, distance is a major factor only for the elderly in determining the amount of utilization.