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Reder S, Hedrick S, Guihan M, Miller S. Barriers to home and community-based service referrals: the physician's role. Gerontology & Geriatrics Education. 2009 Jan 1; 30(1):21-33.
The purpose of this study was to obtain information about Department of Veteran Affairs (VA) long-term care (LTC) referrals that could be used to develop interventions that increase the likelihood of referrals to home and community-based services (HCBS) instead of institutional care. This primarily qualitative study was conducted at five VA Medical Centers. The study used three linked methods: interviews with patients and informal caregivers; focus groups with LTC administrators, providers, and social workers; and written rankings of the barriers to HCBS referrals. We unexpectedly identified a cluster of findings indicating the importance of physicians'' role in the LTC referral process and the need for more LTC training, particularly about HCBS.