Physical and Mental Health and Access to Care Among Nonmetropolitan Veterans Health Administration Patients Younger Than 65 Years

Abstract

VA can anticipate increasing demand for mental and physical health care among rural veterans younger than 65 years.

Mental Health Service Utilization Among Patients with Severe Mental Disorders

“…Even if Canada provides public healthcare coverage as in most European countries (coverage akin to that enjoyed by U.S. residents with insurance, particularly patients with SMD covered under Medicare and/or Medicaid programs), it ranks close to the U.S. system in terms of population access to care, that is, fairly low compared to other OECD (Organisation for Economic Co-operation and Development) countries (Schoen et al 2007;). Access to continuous care from family physicians and psychiatrists for patients with SMD in rural or remote areas is also a problem in most countries (Bambling et al 2007;Starkes et al 2005;West and Weeks 2005). Furthermore, improving continuity of care and addressing multiple patient needs are challenges common to all countries (WHO/Wonca 2008); therefore, multiplesite studies on service utilization by patients with SMD in different countries are needed.…”

Comparing VA and Non-VA Quality of Care: A Systematic Review

“…51 Receipt of diabetes education and annual HbA1c tests was higher among VA patients compared with veterans in non-VA care. 52 VA patients were more likely than veterans receiving care outside VA to receive recommended diabetes care, including being twice as likely to have a foot examination and 60-70 % more likely to have an eye examination, two or more A1c tests, and two or more providers visits, 53 a routine checkup within 2 years (91.6 % among VA patients compared to 80.6 % overall; P < 0.001), 54 and influenza and pneumonia vaccinations (rates increased 10-240 %), 53,55,56 but similar rates of cholesterol screening. 55 Blood pressure control was higher among male African-American VA patients than male African-American non-VA patients (49.4 % vs. 44.0 %, P < 0.01) though similar among Caucasians.…”

Access to care for vulnerable veterans with hepatitis C: a hybrid conceptual framework and a case study to guide translation

“…Because of these geographic and social PRACTICE AND PUBLIC HEALTH POLICY factors, they have less access to both VHA and non-VHA care [45]. Compared to urban veterans, rural veterans have lower quality of life, higher hospital readmission rates, less access to specialty and mental health services, and are vulnerable to urban healthcare regionalization [46][47][48][49][50][51]. In an integrated healthcare system such as the VHA, understanding geographic differences in disease prevalence as well as access to care guide targeting of liver telemedicine initiatives.…”