Rural Veterans are facing more barriers to health care than those living in urban areas. Not only have it reduced Use of medical facilities, providers and medical transportation services, rural veteran soldiers lower Quality control and larger communication barrier Less Advanced information technology.
The problem is much greater for those who receive long -term support and services based on home and community. Understanding the relative benefits of self -directing services compared to other paid housing and community -based private nursing services in rural areas is particularly interested in the Veterans Health Bureau (VHA). 3 million veterans The age of 65 or older lives in the countryside.
Example of self -directed program, the Veteran (VDC) programs help people (including family or neighbors), helping veterans to live independently in their homes (including family or neighbors), or to revise their homes or houses. Family workers or paid families help you to wear daily activities (for example, meals, trims, and clothes.
New evidence:
In January 2022, the evaluator of the partner evidence -based policy resource center (peprec) Publishing A paper The title of the title is in the Journal of the American Geriatrics Society, “Reduces health care events that can be avoided by rural Veterans with self -oriented treatment and other personal nursing services.The goal is rural and urban veteran soldiers. It was to understand whether the nursing home, acute nursing home or emergency room (ED) treatment was used. attache VDC registration, registration compared to the recipient of other VHA-PAID personal management services.
methods:
Subsequently, the fragrance observation study included more than 37,000 veterans who received VHA-PAID home and community-based long-term treatment services in the fiscal year of 2017. Using VHA management data on the use of health status and health care, the evaluator compared the difference in the results of the VHA fuel personal management service program for VDC programming and rural and urban areas. The reference period was 12 months before the start of the service and the result was 12 months after the start of the service.
They used the Logistic Regression Model, which was hierarched by location (rural/city), to estimate the relationship between VDC receipt and VHA-PAID community or in-house hospitals, nursing homes and ED services. Sensitivity analysis also matched Veterans in multiple covariates (eg, age, dementia, companionship, etc.).
result :
The author found that both the Rural and Urban VDC recipients have less admission to the VHA-conservative community and in-house nursing home compared to other VHA-sent personal management services. Rural VDC registrants have a VHA-conservative community and in-house acute treatment, VHA-PAID community and in-house ED, unlike URBAN VDC registrants who have not changed significantly before after the start of the service.
In terms of demographic statistics, the VDC recipient was younger and more VHA. Priority (Important health problems and/or obstacles, high financial needs), it was more likely to have been spinalized than the recipient of other VHA-PAID Personal Care Services programs.
conclusion:
There were several limitations in this study. For example, this data did not include long-term treatment services (eg, pockets or personal insurance) long-term treatment services, and the evaluator did not compare the management costs between the VDC program and other VHA-PAID personal management services. The study also could not determine the extent that the health results caused by the existence of the VDC program or the strong family caregiver were improved.
This research suggests that the VDC program is an appropriate and beneficial treatment option for Veterans with multiple chronic conditions and/or cognitive impairment, and can be particularly beneficial for Veterans who live in rural areas. It also has the potential to reduce the use of VHA-PAID community and in-house health care than other VHA-PAID personal management services. In the future research, it is necessary to continue to explore the degree of changing nursing nursing and nursing home admissions among VDC winners, not VHA.
PEPREC is a team of health economists, public health researchers and policy analysts who support VA efforts to improve the lives of Veterans by using advanced quantum methods that are mostly funded by QUERI in the Veterans Health Bureau.
