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Using Mixed Methods to Investigate Use of Veterans Affairs Telehealth Services During Disasters

Der-Martirosian C, Chu K, Griffin A, Dobalian A. Using Mixed Methods to Investigate Use of Veterans Affairs Telehealth Services During Disasters. SAGE Research Methods Cases. 2020 Jan 1; doi:10.4135/9781529740455.

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This case study uses a convergent mixed-methods approach with data from two distinct qualitative and quantitative studies examining the impact of Hurricane Sandy at the Manhattan VA Medical Center. Semi-structured, in-person interviews were conducted with key informants 3 months after Sandy made landfall in October 2012. During the initial set of qualitative analyses, use of telehealth services emerged as a new theme. The quantitative study was based on Veterans Affairs administrative and clinical datasets of patient health records, where we examined the use of all outpatient services 12-months before and 12-months after Sandy made landfall. We used SQL, SAS, and Stata within the Veterans Affairs centralized virtual platform to merge data files, manage datasets, create study cohorts, and conduct statistical analyses. The quantitative study findings indicated a substantial increase in the use of telehealth services during the 7-month period when the Manhattan VA Medical Center was closed because of major flood damage sustained from Sandy. This unanticipated research finding has led to a new, understudied research topic in disaster research. Within the context of disasters, oftentimes the availability and access to the type of data guides the type of research methodology used in health services studies. Future studies in disaster research should try to use mixed methods when possible, with the intention of examining the process of impact, response, and recovery, as well as studying the overall patterns of use of health care services before and after an event.

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