Journal article
Echocardiogram Utilization Among Rural and Urban Veterans
The Journal of rural health, Vol.28(2), pp.211-220
2012
DOI: 10.1111/j.1748-0361.2011.00380.x
PMCID: PMC3319196
PMID: 22236338
Abstract
Purpose: To compare echocardiography use among urban and rural veterans and whether differences could be accounted for by distance.
Methods: We used Veterans Administration (VA) administrative data from 1999 to 2007 to identify regular users of the VA Healthcare System (VA users) who did and did not receive echocardiography. Each veteran was categorized as residing in urban, rural or highly rural areas using RUCA codes. Poisson regression was used to compare echocardiography utilization rates among veterans residing in each area after adjusting for demographics, comorbidities, clustering of patients within VA networks and distance to the nearest VA medical center offering echocardiography.
Findings: Our study included 22.7 million veterans of whom 1.3 million (5.7%) received at least 1 echocardiogram. Of echocardiography recipients, 69.2% lived in urban, 22.0% in rural and 8.8% in highly rural areas. In analyses adjusting for patient demographics, comorbidities, and clustering, utilization of echocardiography was modestly lower for highly rural and rural veterans compared with urban veterans (42.0 vs 40.1 vs 43.1 echocardiograms per 1,000 VA users per year for highly rural, rural and urban, respectively; P< .001). After further adjusting for distance, echocardiography utilization was somewhat higher for veterans in highly rural and rural areas than it was for urban areas (44.9 vs 41.8 vs 40.8 for highly rural, rural and urban, respectively; P< .001).
Conclusions: Echocardiography utilization among rural and highly rural veterans was marginally lower than for urban veterans, but these differences can be accounted for by the greater distance of more rural veterans from facilities offering echocardiograms.
Details
- Title: Subtitle
- Echocardiogram Utilization Among Rural and Urban Veterans
- Creators
- Kingston Okrah - Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaMary Vaughan-Sarrazin - Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Administration Medical Center, Iowa City, IowaPeter Kaboli - Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Administration Medical Center, Iowa City, IowaPeter Cram - Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Administration Medical Center, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of rural health, Vol.28(2), pp.211-220
- DOI
- 10.1111/j.1748-0361.2011.00380.x
- PMID
- 22236338
- PMCID
- PMC3319196
- NLM abbreviation
- J Rural Health
- ISSN
- 0890-765X
- eISSN
- 1748-0361
- Grant note
- T32 HL007121-37 || HL / National Heart, Lung, and Blood Institute : NHLBI
- Language
- English
- Date published
- 2012
- Academic Unit
- Health Management and Policy; Epidemiology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984063112202771
Metrics
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