Journal article
A Longitudinal Evaluation of a Novel Short-Term Staffing and Telehealth Program: A Retrospective Observational Study
Journal of primary care & community health, Vol.17, pp.1-9
01/2026
DOI: 10.1177/21501319261424758
PMID: 41762217
Abstract
Primary care is foundational to health, but provider shortages impact access. In the Veterans Health Administration (VHA), Clinical Resource Hubs (CRH) provide remote clinicians to alleviate short term staffing gaps.
A longitudinal analysis of primary care clinics from October 1, 2020, through September 30, 2024, was conducted. CRH user clinics were those with ≥10 CRH visits/month in 2 consecutive months. A time-varying measure of minimal threshold CRH use (ie, ≥10 CRH visits/month) was also constructed. Outcomes were measured monthly, including established and new patient wait time, third next available appointment (ie, average time to the third open appointment in provider schedule), timely care, and an indicator that 80% of new patients were seen within 20 days. Using a within-between model framework, generalized linear mixed models with robust standard errors assessed the association between CRH use and access to care.
Overall, 37.1% of VHA primary care clinics (N = 366) were CRH users In adjusted models, clinics meeting the time-varying minimal threshold for CRH use versus not was associated with an increase in established patient wait time (β = .35 day, SE = 0.07,
< .001) and new patient wait time (β = .69 day, SE = 0.20,
< .001), and a decrease in timely care (β = -1.40%, SE = 0.21,
< .001).
When CRH was engaged, clinics had marginally longer wait times. Though CRHs have provided remote staffing, additional efficiencies may be needed to close access gaps.
Details
- Title: Subtitle
- A Longitudinal Evaluation of a Novel Short-Term Staffing and Telehealth Program: A Retrospective Observational Study
- Creators
- Paige Carlson - University of IowaBjarni Haraldsson - Iowa City VA Health Care SystemMatthew R Augustine - Geriatric Research Education and Clinical CenterPeter J Kaboli - University of IowaAmy M J O'Shea - Office of Rural Health
- Resource Type
- Journal article
- Publication Details
- Journal of primary care & community health, Vol.17, pp.1-9
- DOI
- 10.1177/21501319261424758
- PMID
- 41762217
- NLM abbreviation
- J Prim Care Community Health
- ISSN
- 2150-1327
- eISSN
- 2150-1327
- Publisher
- Sage
- Grant note
- office of rural healthVHA Office of Primary CareOffice of Research and Development: CIN 13-412 u.s. department of veterans affairsVeterans Rural Health Resource Center
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This material is based upon work supported (or supported in part) by the VHA Primary Care Analytics Team (PCAT), funded by the VHA Office of Primary Care, as well as the Department of Veterans Affairs, Veterans Health Administration, Office of Rural Health, Veterans Rural Health Resource Center - Iowa City, and the Office of Research and Development, Health Services Research and Development (HSR&D) Service through the Comprehensive Access and Delivery Research and Evaluation (CADRE) Center (CIN 13-412). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. This manuscript is not under review elsewhere and there is no prior publication of manuscript contents. The preliminary results of this manuscript were presented at the Society of General Internal Medicine Meeting; Boston, Massachusetts in May 2024 and the Annual Meeting of Academy Health; Baltimore Maryland in June 2024.
- Language
- English
- Date published
- 01/2026
- Academic Unit
- Epidemiology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9985139310802771
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