JGIM Special Issue on Improving Access to VA Care
BACKGROUND:
VA has the largest integrated healthcare system in America, serving more than 9 million Veterans across almost 1,300 healthcare facilities. Providing Veterans access to timely, high-quality care has always been a key priority. VA’s Veteran Access Research Consortium (VARC) – one of HSR&D’s COnsortia of REsearch (COREs) – sought input from a network of access researchers, operational leaders, and Veterans to shape research priorities for healthcare access. This supplement built on that work by soliciting submissions aligned with three domains identified as being the highest priority for VA access research: 1) Access measurement, 2) Equity and subpopulations (e.g., racial/ethnic minorities, women, LGBTQ+ Veterans), and 3) Effective interventions to improve access.
Funded by HSR&D, this special issue of the Journal of General Internal Medicine titled “Veterans’ Access to Care” highlights recent advancements in access-related research and illustrates how VA has evolved in its ongoing journey to be a high-reliability organization using a learning healthcare system framework to improve access to care. Articles include, but are not limited to:
- Arredondo et al., discuss their narrative review of the literature to identify and compare current incentives offered by physician shortages in rural settings to better understand how resources are allocated to vulnerable areas.
- Cusick et al., report on a regional initiative to coordinate care for Veterans across two healthcare systems that resulted in more continuity within VA for patients and improved efficiency.
- Dodge et al., highlight the paramount importance of partnerships between researchers and operational offices to ensure that effective access-related interventions are implemented into routine practice
- Kalofonos et al., describe lessons learned from a sanctioned encampment to provide housing and healthcare to Veterans experiencing homelessness during the pandemic at the Greater Los Angeles VA, an innovative and proactive approach to one of society’s biggest challenges.
- Mahorter et al., discuss access to long-acting reversible contraception (LARC), examining variations in rates of LARC by rurality and facility type.
- Patzel et al., report on the challenges of non-VA primary care providers who care for Veterans and address three determinants of access: provider, health system, and community perspectives.
- Possemato et al., describe a randomized controlled trial of a “PTSD Coach” mobile app that resulted in improved access and quality, outcomes, and satisfaction for Veterans with PTSD.
For decades VA has invested in strengthening its capacities as a learning healthcare system. Partnerships between clinicians, leadership, researchers, Veterans, and national program offices support meaningful improvements in access to quality care for all Veterans. By continuing on this path, with increasing transparency in how access to care for Veterans is measured, reported, and improved, VA has the potential to serve as the standard by which other healthcare systems are compared.
Funded by HSR&D and edited by Peter Kaboli, MD and Stephanie Shimada, PhD, co-PIs of VARC, along with Gemmae Fix, PhD, and Renuka Tipirneni, PhD, this special issue of JGIM is a testament to VA’s ongoing dedication to a continuously learning health system.
Journal of General Internal Medicine. Veterans’ Access to Care. Special issue includes 19 articles. July 2023;(38)3.
