Home Modifications for Rural Veterans With Disabilities.

Journal

Federal practitioner : for the health care professionals of the VA, DoD, and PHS
ISSN: 1078-4497
Titre abrégé: Fed Pract
Pays: United States
ID NLM: 9500574

Informations de publication

Date de publication:
Jul 2021
Historique:
entrez: 4 11 2021
pubmed: 5 11 2021
medline: 5 11 2021
Statut: ppublish

Résumé

Appropriate home modifications (HMs) can make the home environment accessible and relatively safe by reducing the risk of falls. Of special concern are individuals living alone, living in rural communities, and/or living in substandard housing. The Home Improvements and Structural Alterations (HISA) is a Veterans Health Administration (VHA) benefit program providing HMs for veterans with disabilities. The objective of this study was to detail the profile of rural veteran (RV) HISA users and report on national HISA utilization patterns. We compare use at US Department of Veterans Affairs (VA) medical centers of varying complexity levels, and in VA regions. An examination of the relationship between travel time/distance and HISA utilization is also provided. This retrospective database study uses GeoSpatial analyses and 3 VA sources: The National Prosthetics Patient Database, the VHA Medical Inpatient Dataset, and the VHA Outpatient Dataset. From 2015 through 2018, 10,810 RVs used HISA with a mean age of 70.9 years. A majority of participants were White (79.5%), married (74.3%), and male (96.5%) veterans. They traveled a mean of 79.8 miles for 94.5 minutes to reach a facility where they received a HISA prescription. Nearly 75% of HISA users were able to receive a HISA prescription from their nearest facility, while about one-quarter traveled to a facility farther away, of which 43% travelled between 100 and 200 miles to obtain the HISA benefit. The top categories of diagnoses were musculoskeletal (19.1%), neurologic (12.5%), and cardiovascular (5.4%). There were about 11,166 HM prescriptions afforded to rural HISA users during the period, including bathroom (82.4%), doorway (4.9%), and railing (3.6%) modifications. This study documents the national demographics and clinical characteristics of rural HISA users, data that may be useful to policy makers, HM service providers and advocate as well as HISA administrators in predicting future use and users.

Sections du résumé

BACKGROUND BACKGROUND
Appropriate home modifications (HMs) can make the home environment accessible and relatively safe by reducing the risk of falls. Of special concern are individuals living alone, living in rural communities, and/or living in substandard housing. The Home Improvements and Structural Alterations (HISA) is a Veterans Health Administration (VHA) benefit program providing HMs for veterans with disabilities.
METHODS METHODS
The objective of this study was to detail the profile of rural veteran (RV) HISA users and report on national HISA utilization patterns. We compare use at US Department of Veterans Affairs (VA) medical centers of varying complexity levels, and in VA regions. An examination of the relationship between travel time/distance and HISA utilization is also provided. This retrospective database study uses GeoSpatial analyses and 3 VA sources: The National Prosthetics Patient Database, the VHA Medical Inpatient Dataset, and the VHA Outpatient Dataset.
RESULTS RESULTS
From 2015 through 2018, 10,810 RVs used HISA with a mean age of 70.9 years. A majority of participants were White (79.5%), married (74.3%), and male (96.5%) veterans. They traveled a mean of 79.8 miles for 94.5 minutes to reach a facility where they received a HISA prescription. Nearly 75% of HISA users were able to receive a HISA prescription from their nearest facility, while about one-quarter traveled to a facility farther away, of which 43% travelled between 100 and 200 miles to obtain the HISA benefit. The top categories of diagnoses were musculoskeletal (19.1%), neurologic (12.5%), and cardiovascular (5.4%). There were about 11,166 HM prescriptions afforded to rural HISA users during the period, including bathroom (82.4%), doorway (4.9%), and railing (3.6%) modifications.
CONCLUSIONS CONCLUSIONS
This study documents the national demographics and clinical characteristics of rural HISA users, data that may be useful to policy makers, HM service providers and advocate as well as HISA administrators in predicting future use and users.

Identifiants

DOI: 10.12788/fp.0153 PMID: 34733079 PMC: PMC8560115
pubmed: 34733079
doi: 10.12788/fp.0153
pii: fp-38-07-300
pmc: PMC8560115
doi:

Types de publication

Journal Article

Langues

eng

Pagination

300-310

Informations de copyright

Copyright © 2021 Frontline Medical Communications Inc., Parsippany, NJ, USA.

Déclaration de conflit d'intérêts

Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.

Références

J Multidiscip Healthc. 2020 Jul 01;13:559-570
pubmed: 32669850
Int J Environ Res Public Health. 2018 Dec 10;15(12):
pubmed: 30544658
Medicine (Baltimore). 2018 May;97(19):e0691
pubmed: 29742717
J Stroke Cerebrovasc Dis. 2018 Apr;27(4):1090-1099
pubmed: 29275059
Perspect Health Inf Manag. 2010 Apr 01;7:1f
pubmed: 20697468
Natl Health Stat Report. 2020 Jun;(142):1-8
pubmed: 32600517
Health Care Financ Rev. 1995 Winter;17(2):147-67
pubmed: 10172614
Med Care. 2015 Jun;53(6):501-9
pubmed: 25961660

Auteurs

Luz M Semeah (LM)

is Principal Investigator and a Health Science Specialist; is a Health Science Specialist; and are Coinvestigators at the Veterans Rural Health Resource Center-GNV; is a Statistician in Research Services; is a retired Research Health Scientist; serves as the Methodologist (for this project); and is a Health Service Research Consultant; all at the North Florida/South Georgia Veteran Health System, Gainesville, Florida. is a Physical Medicine and Rehabilitation Physician at the Charlie Norwood VA Medical Center in Augusta, Georgia. Diane Cowper Ripley is Director Emeritus; is a Health Science Specialist and GIS Analyst; is a Geographer at the GeoSpatial Outcomes Division, US Department of Veterans Affairs Office of Rural Health. Mi Jung Lee is an Assistant Professor at the University of Texas Medical Branch at Galveston in Texas; Zaccheus Ahonle is an Assistant Professor in the Department of Counseling, Educational Psychology and Foundations at Mississippi State University. Shanti Ganesh is a Courtesy Clinical Assistant Professor in the Department of Occupational Therapy, College of Public Health and Health Professions and Deepthi Satheesa Varma is an Assistant Professor in the Department of Epidemiology at the University of Florida.

Tatiana Orozco (T)

is Principal Investigator and a Health Science Specialist; is a Health Science Specialist; and are Coinvestigators at the Veterans Rural Health Resource Center-GNV; is a Statistician in Research Services; is a retired Research Health Scientist; serves as the Methodologist (for this project); and is a Health Service Research Consultant; all at the North Florida/South Georgia Veteran Health System, Gainesville, Florida. is a Physical Medicine and Rehabilitation Physician at the Charlie Norwood VA Medical Center in Augusta, Georgia. Diane Cowper Ripley is Director Emeritus; is a Health Science Specialist and GIS Analyst; is a Geographer at the GeoSpatial Outcomes Division, US Department of Veterans Affairs Office of Rural Health. Mi Jung Lee is an Assistant Professor at the University of Texas Medical Branch at Galveston in Texas; Zaccheus Ahonle is an Assistant Professor in the Department of Counseling, Educational Psychology and Foundations at Mississippi State University. Shanti Ganesh is a Courtesy Clinical Assistant Professor in the Department of Occupational Therapy, College of Public Health and Health Professions and Deepthi Satheesa Varma is an Assistant Professor in the Department of Epidemiology at the University of Florida.

Xinping Wang (X)

is Principal Investigator and a Health Science Specialist; is a Health Science Specialist; and are Coinvestigators at the Veterans Rural Health Resource Center-GNV; is a Statistician in Research Services; is a retired Research Health Scientist; serves as the Methodologist (for this project); and is a Health Service Research Consultant; all at the North Florida/South Georgia Veteran Health System, Gainesville, Florida. is a Physical Medicine and Rehabilitation Physician at the Charlie Norwood VA Medical Center in Augusta, Georgia. Diane Cowper Ripley is Director Emeritus; is a Health Science Specialist and GIS Analyst; is a Geographer at the GeoSpatial Outcomes Division, US Department of Veterans Affairs Office of Rural Health. Mi Jung Lee is an Assistant Professor at the University of Texas Medical Branch at Galveston in Texas; Zaccheus Ahonle is an Assistant Professor in the Department of Counseling, Educational Psychology and Foundations at Mississippi State University. Shanti Ganesh is a Courtesy Clinical Assistant Professor in the Department of Occupational Therapy, College of Public Health and Health Professions and Deepthi Satheesa Varma is an Assistant Professor in the Department of Epidemiology at the University of Florida.

Mi Jung Lee (MJ)

is Principal Investigator and a Health Science Specialist; is a Health Science Specialist; and are Coinvestigators at the Veterans Rural Health Resource Center-GNV; is a Statistician in Research Services; is a retired Research Health Scientist; serves as the Methodologist (for this project); and is a Health Service Research Consultant; all at the North Florida/South Georgia Veteran Health System, Gainesville, Florida. is a Physical Medicine and Rehabilitation Physician at the Charlie Norwood VA Medical Center in Augusta, Georgia. Diane Cowper Ripley is Director Emeritus; is a Health Science Specialist and GIS Analyst; is a Geographer at the GeoSpatial Outcomes Division, US Department of Veterans Affairs Office of Rural Health. Mi Jung Lee is an Assistant Professor at the University of Texas Medical Branch at Galveston in Texas; Zaccheus Ahonle is an Assistant Professor in the Department of Counseling, Educational Psychology and Foundations at Mississippi State University. Shanti Ganesh is a Courtesy Clinical Assistant Professor in the Department of Occupational Therapy, College of Public Health and Health Professions and Deepthi Satheesa Varma is an Assistant Professor in the Department of Epidemiology at the University of Florida.

Zaccheus James Ahonle (ZJ)

is Principal Investigator and a Health Science Specialist; is a Health Science Specialist; and are Coinvestigators at the Veterans Rural Health Resource Center-GNV; is a Statistician in Research Services; is a retired Research Health Scientist; serves as the Methodologist (for this project); and is a Health Service Research Consultant; all at the North Florida/South Georgia Veteran Health System, Gainesville, Florida. is a Physical Medicine and Rehabilitation Physician at the Charlie Norwood VA Medical Center in Augusta, Georgia. Diane Cowper Ripley is Director Emeritus; is a Health Science Specialist and GIS Analyst; is a Geographer at the GeoSpatial Outcomes Division, US Department of Veterans Affairs Office of Rural Health. Mi Jung Lee is an Assistant Professor at the University of Texas Medical Branch at Galveston in Texas; Zaccheus Ahonle is an Assistant Professor in the Department of Counseling, Educational Psychology and Foundations at Mississippi State University. Shanti Ganesh is a Courtesy Clinical Assistant Professor in the Department of Occupational Therapy, College of Public Health and Health Professions and Deepthi Satheesa Varma is an Assistant Professor in the Department of Epidemiology at the University of Florida.

Diane C Cowper Ripley (DC)

is Principal Investigator and a Health Science Specialist; is a Health Science Specialist; and are Coinvestigators at the Veterans Rural Health Resource Center-GNV; is a Statistician in Research Services; is a retired Research Health Scientist; serves as the Methodologist (for this project); and is a Health Service Research Consultant; all at the North Florida/South Georgia Veteran Health System, Gainesville, Florida. is a Physical Medicine and Rehabilitation Physician at the Charlie Norwood VA Medical Center in Augusta, Georgia. Diane Cowper Ripley is Director Emeritus; is a Health Science Specialist and GIS Analyst; is a Geographer at the GeoSpatial Outcomes Division, US Department of Veterans Affairs Office of Rural Health. Mi Jung Lee is an Assistant Professor at the University of Texas Medical Branch at Galveston in Texas; Zaccheus Ahonle is an Assistant Professor in the Department of Counseling, Educational Psychology and Foundations at Mississippi State University. Shanti Ganesh is a Courtesy Clinical Assistant Professor in the Department of Occupational Therapy, College of Public Health and Health Professions and Deepthi Satheesa Varma is an Assistant Professor in the Department of Epidemiology at the University of Florida.

Shanti P Ganesh (SP)

is Principal Investigator and a Health Science Specialist; is a Health Science Specialist; and are Coinvestigators at the Veterans Rural Health Resource Center-GNV; is a Statistician in Research Services; is a retired Research Health Scientist; serves as the Methodologist (for this project); and is a Health Service Research Consultant; all at the North Florida/South Georgia Veteran Health System, Gainesville, Florida. is a Physical Medicine and Rehabilitation Physician at the Charlie Norwood VA Medical Center in Augusta, Georgia. Diane Cowper Ripley is Director Emeritus; is a Health Science Specialist and GIS Analyst; is a Geographer at the GeoSpatial Outcomes Division, US Department of Veterans Affairs Office of Rural Health. Mi Jung Lee is an Assistant Professor at the University of Texas Medical Branch at Galveston in Texas; Zaccheus Ahonle is an Assistant Professor in the Department of Counseling, Educational Psychology and Foundations at Mississippi State University. Shanti Ganesh is a Courtesy Clinical Assistant Professor in the Department of Occupational Therapy, College of Public Health and Health Professions and Deepthi Satheesa Varma is an Assistant Professor in the Department of Epidemiology at the University of Florida.

Eric R Litt (ER)

is Principal Investigator and a Health Science Specialist; is a Health Science Specialist; and are Coinvestigators at the Veterans Rural Health Resource Center-GNV; is a Statistician in Research Services; is a retired Research Health Scientist; serves as the Methodologist (for this project); and is a Health Service Research Consultant; all at the North Florida/South Georgia Veteran Health System, Gainesville, Florida. is a Physical Medicine and Rehabilitation Physician at the Charlie Norwood VA Medical Center in Augusta, Georgia. Diane Cowper Ripley is Director Emeritus; is a Health Science Specialist and GIS Analyst; is a Geographer at the GeoSpatial Outcomes Division, US Department of Veterans Affairs Office of Rural Health. Mi Jung Lee is an Assistant Professor at the University of Texas Medical Branch at Galveston in Texas; Zaccheus Ahonle is an Assistant Professor in the Department of Counseling, Educational Psychology and Foundations at Mississippi State University. Shanti Ganesh is a Courtesy Clinical Assistant Professor in the Department of Occupational Therapy, College of Public Health and Health Professions and Deepthi Satheesa Varma is an Assistant Professor in the Department of Epidemiology at the University of Florida.

Lauren K Wilson (LK)

is Principal Investigator and a Health Science Specialist; is a Health Science Specialist; and are Coinvestigators at the Veterans Rural Health Resource Center-GNV; is a Statistician in Research Services; is a retired Research Health Scientist; serves as the Methodologist (for this project); and is a Health Service Research Consultant; all at the North Florida/South Georgia Veteran Health System, Gainesville, Florida. is a Physical Medicine and Rehabilitation Physician at the Charlie Norwood VA Medical Center in Augusta, Georgia. Diane Cowper Ripley is Director Emeritus; is a Health Science Specialist and GIS Analyst; is a Geographer at the GeoSpatial Outcomes Division, US Department of Veterans Affairs Office of Rural Health. Mi Jung Lee is an Assistant Professor at the University of Texas Medical Branch at Galveston in Texas; Zaccheus Ahonle is an Assistant Professor in the Department of Counseling, Educational Psychology and Foundations at Mississippi State University. Shanti Ganesh is a Courtesy Clinical Assistant Professor in the Department of Occupational Therapy, College of Public Health and Health Professions and Deepthi Satheesa Varma is an Assistant Professor in the Department of Epidemiology at the University of Florida.

Deepthi Satheesa Varma (DS)

is Principal Investigator and a Health Science Specialist; is a Health Science Specialist; and are Coinvestigators at the Veterans Rural Health Resource Center-GNV; is a Statistician in Research Services; is a retired Research Health Scientist; serves as the Methodologist (for this project); and is a Health Service Research Consultant; all at the North Florida/South Georgia Veteran Health System, Gainesville, Florida. is a Physical Medicine and Rehabilitation Physician at the Charlie Norwood VA Medical Center in Augusta, Georgia. Diane Cowper Ripley is Director Emeritus; is a Health Science Specialist and GIS Analyst; is a Geographer at the GeoSpatial Outcomes Division, US Department of Veterans Affairs Office of Rural Health. Mi Jung Lee is an Assistant Professor at the University of Texas Medical Branch at Galveston in Texas; Zaccheus Ahonle is an Assistant Professor in the Department of Counseling, Educational Psychology and Foundations at Mississippi State University. Shanti Ganesh is a Courtesy Clinical Assistant Professor in the Department of Occupational Therapy, College of Public Health and Health Professions and Deepthi Satheesa Varma is an Assistant Professor in the Department of Epidemiology at the University of Florida.

Huanguang Jia (H)

is Principal Investigator and a Health Science Specialist; is a Health Science Specialist; and are Coinvestigators at the Veterans Rural Health Resource Center-GNV; is a Statistician in Research Services; is a retired Research Health Scientist; serves as the Methodologist (for this project); and is a Health Service Research Consultant; all at the North Florida/South Georgia Veteran Health System, Gainesville, Florida. is a Physical Medicine and Rehabilitation Physician at the Charlie Norwood VA Medical Center in Augusta, Georgia. Diane Cowper Ripley is Director Emeritus; is a Health Science Specialist and GIS Analyst; is a Geographer at the GeoSpatial Outcomes Division, US Department of Veterans Affairs Office of Rural Health. Mi Jung Lee is an Assistant Professor at the University of Texas Medical Branch at Galveston in Texas; Zaccheus Ahonle is an Assistant Professor in the Department of Counseling, Educational Psychology and Foundations at Mississippi State University. Shanti Ganesh is a Courtesy Clinical Assistant Professor in the Department of Occupational Therapy, College of Public Health and Health Professions and Deepthi Satheesa Varma is an Assistant Professor in the Department of Epidemiology at the University of Florida.

Classifications MeSH