Rural Veterans: State of the Science and Future Directions

Access to a full and comprehensive spectrum of quality health care services is the central challenge facing many rural communities; unique veterans' rural health needs, especially among returning OEF/OIF veterans, may present additional challenges. Several observational studies have suggested that rural veterans face disparities in both health status (primarily quality-of-life measures) and utilization (perhaps reflective of access or payer-mix issues). The disease burden among rural veterans appears to be high, with particular challenges in mental health and long-term care. The published literature suggests that greater travel distances and financial barriers to access are likely to impede access, undermine coordination, and threaten quality of care for many rural veterans. The VA continues to employ a number of strategies to more effectively serve rural veterans. Evaluations of these approaches in the published literature suggest that, while practice patterns may differ in rural settings, the expansion of Community-Based Outpatient Clinics, Outreach Clinics, and Care Coordination Home Telehealth approaches are effective strategies for improving access. This session reviews the published literature on rural veterans and supplements this with perspectives gathered from structured interviews conducted over two months with rural health experts. The session lays out what we know about veterans in rural and frontier settings, outlines potential research directions, possible strategies for improving care for rural veterans, and updates the actions and progress of the VA's Office of Rural Health.