Journal article
Home health utilization in the Veterans Health Administration: Are there rural and urban differences?
The Journal of rural health, Vol.41(1), e12865
01/2025
DOI: 10.1111/jrh.12865
PMCID: PMC11635398
PMID: 39075777
Appears in UI Libraries Support Open Access
Abstract
Abstract Purpose Growing numbers of older adults need home health care, yhese services may be more difficult to access for rural Veterans, who represent one‐third of Veterans Health Administration (VA) enrollees. Our objective was to examine whether home health use differs within VA based on rurality. Methods We examined national VA administrative data for 2019–2021 (January 1, 2019 to December 31, 2021) among Veterans ages ≥65 years. Using descriptive and multivariable analyses, we assessed whether rural versus urban Veterans differed in (1) the likelihood of using any home health and (2) for those who received ≥1 visit, number of visits received. Results Among home health users ( n = 107,229, 33.1% rural), rural and urban Veterans were similar in age (77.0 vs. 77.2 years). Rural Veterans were less likely to be highly frail (38.9% rural vs. 40.4% urban) or diagnosed with dementia (13.5% vs. 17.6%). After adjusting for Veterans’ characteristics, rural Veterans were more likely to receive any home health (odds ratio: 1.10; 95% confidence interval [CI]: 1.07, 1.13). Among Veterans who received ≥1 home health visit, rurality was associated with considerably fewer expected visits (incident rate ratio: 0.70; 95% CI: 0.68, 0.72). Conclusions Although rural Veterans were more likely than urban Veterans to receive any home health services, they received considerably fewer home health visits. This difference may represent an access issue for rural Veterans. Future research is needed to identify reasons for these differences and develop strategies to ensure rural Veterans’ care needs are equitability addressed.
Details
- Title: Subtitle
- Home health utilization in the Veterans Health Administration: Are there rural and urban differences?
- Creators
- Heather Davila - Iowa City VA Health Care SystemBradely Mayfield - VA Puget Sound Health Care SystemMichelle A. Mengeling - University of IowaAndrea Holcombe - University of Iowa, NeurologyKelly R. Miell - Iowa City VA Health Care SystemErin Jaske - VA Puget Sound Health Care SystemWilliam Iverson - University of IowaTammy Walkner - Iowa City VA Health Care SystemGreg Stewart - University of IowaSamantha Solimeo - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of rural health, Vol.41(1), e12865
- DOI
- 10.1111/jrh.12865
- PMID
- 39075777
- PMCID
- PMC11635398
- NLM abbreviation
- J Rural Health
- ISSN
- 0890-765X
- eISSN
- 1748-0361
- Publisher
- Wiley
- Language
- English
- Electronic publication date
- 07/29/2024
- Date published
- 01/2025
- Academic Unit
- Neurology; Management and Entrepreneurship ; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984691559702771
Metrics
8 Record Views