Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, CA, USA; 795 Willow Rd., C-102, Menlo Park, CA 94025, USA.
Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, CA, USA; 795 Willow Rd., Menlo Park, CA 94025, USA.
Disabil Health J. 2024 Jan;17(1):101515. doi: 10.1016/j.dhjo.2023.101515. Epub 2023 Aug 2.
Persons with disabilities experience significant physical, attitudinal, and communication-based barriers to accessing care. These challenges are exacerbated for rural-dwelling persons with disabilities. Although US Veterans experience disabilities at a higher rate than non-Veterans and are also more likely to dwell in rural locations, research examining the accessibility of VA care for rural Veterans with disabilities is limited.
With a focus on access and accessibility, we sought to explore the experiences of rural Veterans with disabilities who receive care at VA.
We conducted 30 qualitative interviews with rural-dwelling Veterans who experience at least one of three types of disabilities: hearing loss, vision loss, and mobility loss. Using a descriptive qualitative approach, we focused on creating a taxonomy of potential access barriers experienced among this population.
Participants reported experiencing access barriers in five main areas, including policies and operational processes at VA clinics; navigating VA campuses and clinics; limited transportation and parking options; communicating with healthcare personnel and occasional negative interactions; and challenges due to pandemic-related changes in policies and procedures.
These findings suggest that Veterans with disabilities may experience a host of challenges and access barriers while navigating the VA Healthcare system. While these challenges have been reported among individuals with disabilities receiving care in other healthcare settings, they have not been assessed in VA specifically. Given its focus on caring for Veterans with service-aggravated conditions and its commitment to equity and inclusion, addressing access barriers among Veterans with disabilities should be a high priority for VA.
残疾人在获得医疗护理方面面临着重大的身体、态度和沟通障碍。对于居住在农村地区的残疾人来说，这些挑战更加严重。尽管美国退伍军人的残疾率高于非退伍军人，而且更有可能居住在农村地区，但对于研究农村地区残疾退伍军人获得 VA 护理的可及性的研究还很有限。
我们重点关注可及性和可及性，旨在探讨在 VA 接受护理的农村残疾退伍军人的经历。
我们对至少患有三种残疾之一的农村居住退伍军人进行了 30 次定性访谈：听力损失、视力损失和行动能力损失。我们采用描述性定性方法，专注于为该人群中潜在的可及性障碍创建一个分类法。
参与者报告在五个主要领域存在可及性障碍，包括 VA 诊所的政策和运营流程；在 VA 校园和诊所中导航；有限的交通和停车选择；与医疗保健人员沟通和偶尔的负面互动；以及与政策和程序相关的大流行变化带来的挑战。
这些发现表明，残疾退伍军人在使用 VA 医疗保健系统时可能会遇到许多挑战和可及性障碍。虽然这些挑战在其他医疗保健环境中接受护理的残疾个体中已经报告过，但在 VA 中尚未进行评估。鉴于其专注于照顾因服务而恶化的条件的退伍军人及其对公平和包容的承诺，解决残疾退伍军人的可及性障碍应该是 VA 的首要任务。
