Study Examines Geographic Access to Rehabilitation for OEF/OIF Veterans
OEF/OIF Veterans are experiencing traumatic injury and/or polytrauma, and therefore may have a greater need for long-term rehabilitation services. However, a report by the VA Office of Inspector General suggests that OEF/OIF Veterans with traumatic injuries experience obstacles in obtaining access to post-acute rehabilitation care. This study sought to ascertain specific geographic areas where the need for VHA rehabilitation services appears greatest and potential access gaps may exist. Investigators identified 7,842 OEF/OIF Veterans with traumatic injuries who accessed VA healthcare during FY03 and FY04, and then mapped Veterans' home ZIP code in relationship to facilities with varying levels of rehabilitation services. Levels of rehabilitation care varied from Level I facilities that provide acute, comprehensive, in-patient rehabilitation care to Level IV facilities that provide a point of contact for referrals to higher-level rehabilitation services.
Findings show that VA provides access to rehabilitation care for the majority of traumatically injured OEF/OIF Veterans; however, more than 10% of Veterans may have potential access barriers due to excessive travel time. For the combined cohort, the median distance to Level I, Level II, and Level III facilities was 411 miles, 121 miles, and 64 miles respectively, and the median distance to the closest VA facility was 22 miles. Clark County, Nevada, and El Paso County, Texas had the highest number of patients with potential access gaps due to excessive travel times. Results also show that the mean age for OEF/OIF Veterans with a traumatic injury was 38.1 years in FY03 and 34.9 in FY04. In both years, hearing impairment was the most common injury, followed by visual impairment.
Cowper Ripley D, Reker D, Hayes J, et al. Geographic Access to VHA Rehabilitation for Traumatic Injured OEF/OIF Veterans. Federal Practitioner October 2009;26(10):28-29, 34-36, 38-39.
This study was funded by HSR&D. Dr. Cowper Ripley is part of HSR&D/RR&D's Rehabilitation Outcomes Research Center in Gainesville, FL; Dr. Reker is part of HSR&D's Center for the Management of Complex Chronic Care in Hines, IL.