Improving Access and Quality Care for Rural Veterans-An Imperative

Kaboli PJ. Improving Access and Quality Care for Rural Veterans-An Imperative. HSR&D FORUM: Translating Research into Quality Healthcare for Veterans. 2010 Nov 1; 4.

Understanding and addressing the needs of rural Veterans requires complementary perspectives including VA Central Office and local administration, policymakers, clinicians, researchers, and most importantly, the patient. For example, one of the fundamental challenges in the care of rural Veterans is distance. However, distance can mean different things to different people with a variety of ways to overcome it. For some Veterans, traveling two hours for a clinic visit can be a welcome social event; for others, it is a barrier to obtaining care. Policies and programs exist to bring care closer to the Veteran including Home Based Primary Care (HBPC), a group effort between the Veteran, family caregiver, VA, and the community. Other policies and programs include telehealth, mobile clinics, and fee-basis care. Yet each of these and other programs has their pros and cons: HBPC may not be cost-effective in highly rural settings; not all Veterans have adequate connectivity for telehealth; mobile clinics have distance, weather, and other limitations; and fee-basis care in the community may contribute to fragmented care.