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Using GIS Tools in Prioritizing Rehabilitation Service Sites for OEF/OIF Veterans

Litt ER, Vogel WB, Kairalla J, Cowper Ripley DC, Wilson LK, Castro JG, Wang X. Using GIS Tools in Prioritizing Rehabilitation Service Sites for OEF/OIF Veterans. Paper presented at: VA HSR&D / QUERI National Meeting; 2012 Jul 19; Washington, DC.


Objectives: To determine where new geographical locations of rehabilitation specialty services can most improve access to such services for OEF/OIF traumatically injured Veterans (i.e., Veterans with traumatic brain injury, spinal cord injury, or traumatic amputation). Methods: Geographic Information System (GIS) software was used to create 120 minute travel time bands around each current Polytrauma Network Site Level 2 VHA rehabilitation facility within the United States. These Level 2 sites provide specialized, post-acute rehabilitation appropriate to the needs of Veterans. The residence location of the OEF/OIF traumatically injured cohort (N = 11,696) was then overlaid on a map and two groups were identified: (1) Veterans within the 120 minute target travel time of a Level 2 VHA Rehab facility, and (2) Veterans residing outside the target travel time, i.e., in "gap areas." Within the gap areas, the number of patients with TBI, SCI, and/or amputation was then aggregated to the ZIP code level (n = 6707). We then produced new 120 minute travel time bands for each VAMC, assuming that a Level 2 unit was established at that facility. We then ranked these alternative Level 2 candidate locations to determine which locations resulted in the greatest increase in the number of Veterans within the 120 minute target travel time. Results: Locating a Level 2 unit at the Long Beach HCS produces the greatest increase in the OEF/OIF population of interest within 120 minutes (985 enrollees). A close second is Loma Linda VAMC with 972 enrollees, followed by West Haven VAMC with 580 enrollees. These results are presented in a series of color-coded maps to aid understanding. Implications: Using GIS to portray large amounts of data is an effective tool in healthcare analysis and decision-making processes. Mapping data and conducting spatial analyses to determine where access gaps exist and the number of patients traveling excessive distances to care can provide useful information about underserved areas. Further, the ability to assess each potential site in terms of the number of Veterans who could be served adds additional information. While there are many other factors that affect the final site choice, results from GIS analyses can identify specific target areas and convey analytical results that are readily understood by a general audience. Impacts: GIS tools help provide data-driven recommendations for new facility locations. Information generated can be used to inform strategic planners where facility placement will reach the maximum number of Veterans.

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