Journal article
Defining "Rural" for Veterans' Health Care Planning
The Journal of rural health, Vol.26(4), pp.301-309
09/2010
DOI: 10.1111/j.1748-0361.2010.00298.x
PMID: 21029164
Abstract
Purpose: The Veterans Health Administration (VHA) devised an algorithm to classify veterans as Urban, Rural, or Highly Rural residents. To understand the policy implications of the VHA scheme, we compared its categories to 3 Office of Management and Budget (OMB) and 4 Rural-Urban Commuting Area (RUCA) geographical categories.
Method: Using residence information for VHA health care enrollees, we compared urban-rural classifications under the VHA, OMB, and RUCA schemes; the distributions of rural enrollees across VHA health care networks (Veterans Integrated Service Networks [VISNs]); and how each scheme indicates whether VHA standards for travel time to care are met for the most rural veterans.
Results: VHA's Highly Rural and Urban categories are much smaller than the most rural or most urban categories in the other schemes, while its Rural category is much larger than their intermediate categories. Most Highly Rural veterans live in VISNs serving the Rocky Mountains and Alaska. Veterans defined as the most rural by RUCA or OMB are distributed more evenly across most VISNs. Nearly all urban enrollees live within VHA standards for travel time to access VHA care; so do most enrollees defined by RUCA or OMB as the most rural. Only half of Highly Rural enrollees, however, live within an hour of primary care, and 70% must travel more than 2 hours to acute care or 4 hours to tertiary care.
Conclusions: VHA's Rural category is very large and broadly dispersed; policy makers should supplement analyses of Rural veterans' health care needs with more detailed breakdowns. Most of VHA's Highly Rural enrollees live in the western United States where distances to care are great and alternative delivery systems may be needed.
Details
- Title: Subtitle
- Defining "Rural" for Veterans' Health Care Planning
- Creators
- Alan N West - Veterans Rural Health Resource Center - Eastern Region, Department of Veterans Affairs, White River Junction, Vermont, and Togus, MaineRichard E Lee - Veterans Rural Health Resource Center - Eastern Region, Department of Veterans Affairs, White River Junction, Vermont, and Togus, MaineMichael D Shambaugh-Miller - Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NebraskaByron D Bair - Veterans Rural Health Resource Center - Western Region, Department of Veterans Affairs, Salt Lake City, UtahKeith J Mueller - Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NebraskaRyan S Lilly - Veterans Rural Health Resource Center - Eastern Region, Department of Veterans Affairs, White River Junction, Vermont, and Togus, MainePeter J Kaboli - Veterans Rural Health Resource Center - Central Region, Department of Veterans Affairs, Iowa City, IowaKara Hawthorne - Office of Rural Health, Department of Veterans Affairs, Washington, DC
- Resource Type
- Journal article
- Publication Details
- The Journal of rural health, Vol.26(4), pp.301-309
- DOI
- 10.1111/j.1748-0361.2010.00298.x
- PMID
- 21029164
- NLM abbreviation
- J Rural Health
- ISSN
- 0890-765X
- eISSN
- 1748-0361
- Publisher
- Blackwell Publishing Inc
- Number of pages
- 9
- Language
- English
- Date published
- 09/2010
- Academic Unit
- Health Management and Policy; Epidemiology; Public Policy Center (Archive); Internal Medicine
- Record Identifier
- 9984094216102771
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