Healthcare Providers for Rural Veterans Literature Review

timer Asked: Mar 30th, 2019
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Question Description

Module 3 Literature Review

Access to Health Care

Find, summarize and discuss in a post of 175-200 words a recent (3-5 years) professional journal article (NOT a website) that presents evidence demonstrating that a specific vulnerable population (disadvantaged population) has poorer access to health care, receives poorer quality of care or experiences greater deficits in health status or health outcomes than less vulnerable populations (more advantaged population). [choose a vulnerable group other than a racial/ethnic population - i.e., there have been many listed thus far in the course ].

Tips for your post/some thoughts on what to include: Be sure to identify the population; what makes this a vulnerable population; how/why do they lack access; are there other contributing factors/risk factors; how does their lack of access impact health status/quality/morbidity/mortality?

Cite your sources and provide references!

Suggestion: Find your article early and post the title and authors in the forum; you can go back later and Edit it to add the rest of your post. Do NOT duplicate articles - you will not receive credit if you post the same article that has already been posted by someone else. Attach the article to the post (if you cannot attach it, choose another one!) so that we all may read it (this is a requirement for credit).

Tutor Answer

School: Carnegie Mellon University

Find the attached completed work, If you have another one, please invite me to bid. Kindly give me a 5 star review to build my profile.


Access to Healthcare
Student’s Name
Institutional Affiliation



Access to Healthcare

The article that I identified for this module is titled Reinventing Veterans Health
Administration: Focus on Primary Care/Practitioner Application and was published on the
Journal of Healthcare Management. The main aim of the article is to assess the manner in which
healthcare may be reinvented so as to improve the access and quality of healthcare services for
veterans in the United States. Veterans are individuals who have in the past served the country in
various positions in the Armed Forces of the United States. Veterans are considered to be a
vulnerable population in the society for several reasons. First, many join the Armed Forces of the
United States when they are young and thereby do not get an opportunity to pursue higher
education compared to their counterparts in the society. This means that their employability is
reduced since they do not possess relevant skills that would allow them to be employed.
Another major reason why they are vulnerable is due to the many injuries that they suffer
when serving the country. These injuries mean that they require enhanced medical services.
Since many are left unemployed after their service, they have low incomes and this reduces their
ability to access healthcare services in the healthcare industry (Armstrong, Levesque, Perlin, &
Rick, 2005). The lack of access to healthcare services has many impacts on their health status
and mortality. First, many die a few years after leaving service since they can no longer afford
medical care due to their low incomes. Secondly, their welfare and well-being is reduced due to
affliction from ailments and diseases. The authors address some of the major ways that primary
care for veterans can be improved without compromising the quality.



Armstrong, B., Levesque, O., Perlin, J. B., Rick, C., & al, e. (2005). Reinventing veterans’ health
administration: Focus on primary Care/PRACTITIONER APPLICATION. Journal of
Healthcare Management, 50(6), 399-408; discussion 409. Retrieved from

Find the attached revised work. Thanks

Ohl et al. BMC Health Services Research (2018) 18:315


Open Access

“Availability of healthcare providers for
rural veterans eligible for purchased care
under the veterans choice act”
Michael E. Ohl1,2,3*, Margaret Carrell4, Andrew Thurman2, Mark Vander Weg2,3, Teresa Hudson Pharm5,
Michelle Mengeling2 and Mary Vaughan-Sarrazin2,3

Background: Military Veterans in the United States are more likely than the general population to live in rural areas,
and often have limited geographic access to Veterans Health Administration (VHA) facilities. In an effort to improve
access for Veterans living far from VHA facilities, the recently-enacted Veterans Choice Act directed VHA to purchase
care from non-VHA providers for Veterans who live more than 40 miles from the nearest VHA facility. To explore
potential impacts of these reforms on Veterans and healthcare providers, we identified VHA-users who were eligible
for purchased care based on distance to VHA facilities, and quantified the availability of various types of non-VHA
healthcare providers in counties where these Veterans lived.
Methods: We combined 2013 administrative data on VHA-users with county-level data on rurality, non-VHA
provider availability, population, household income, and population health status.
Results: Most (77.9%) of the 416,338 VHA-users who were eligible for purchased care based on distance lived in rural
counties. Approximately 16% of these Veterans lived in primary care shortage areas, while the majority (70.2%) lived in
mental health care shortage areas. Most lived in counties that lacked specialized health care providers (e.g. cardiologists,
pulmonologists, and neurologists). Counterintuitively, VHA played a greater role in delivering healthcare for the overall
adult population in counties that were farther from VHA facilities (30.7 VHA-users / 1000 adults in counties over 40 miles
from VHA facilities, vs. 22.4 VHA-users / 1000 adults in counties within 20 miles of VHA facilities, p < 0.01).
Conclusions: Initiatives to purchase care for Veterans living more than 40 miles from VHA facilities may not significantly
improve their access to care, as these areas are underserved by non-VHA providers. Non-VHA providers in the
predominantly rural areas more than 40 miles from VHA facilities may be asked to assume care for relatively large
numbers of Veterans, because VHA has recently cared for a greater proportion of the population in these areas, and
these Veterans are now eligible for purchased care.
Keywords: Access, Veterans, Rural health

Veterans Health Administration (VHA) is the largest integrated healthcare delivery system in the United States
(US), with ~ 5.9 million Veterans using VHA for some
form of healthcare in 2015 [1]. Veterans are more likely
than the overall United States (US) population to live in
* Correspondence:
VA Office of Rural Health (ORH), Veterans Rural Health Resource CenterIowa City, Iowa City VA Medical Center, Iowa City, IA, USA
Center for Comprehensive Access and Delivery Research and Evaluation
(CADRE), Mailstop 152, Iowa City VAMC, 52246m, Iowa City, IA, USA
Full list of author information is available at the end of the article

rural areas. Depending on the method used to define
rural areas, 22–30% of VHA enrollees live in rural areas,
compared to 15–20% of the US population [2, 3]. This
makes VHA an important provider of healthcare in rural
areas of the US.
VHA has worked to improve access to care for rural
Veterans using a variety of strategies, including building
of Community Based Outpatient Clinics (CBOCs) in rural
communities, reimbursing Veterans for travel to VHA
care sites, and promoting use of telehealth [4]. A more recent strategy for improving access relies on purchasing of

© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (, which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
( applies to the data made available in t...

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Good stuff. Would use again.

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