PDF(Pubmed)
Abstract：
BACKGROUND: Access to mental and physical healthcare in rural areas is challenging for Veterans and their families but essential for good health. Even though recent research has revealed some of the challenges rural Veterans face accessing healthcare, a complete understanding of the gap in access is still unclear.
METHODS: This qualitative study aimed to explore participants\' perceptions of healthcare access. Structured interviews were conducted with 124 Veterans and spouses of Veterans from rural qualifying counties in South Carolina and Florida.
RESULTS: The study\'s results revealed five main dimensions of access: geographic proximity, transportation, communication, cultural competence, and resources. Distance to service needed can negatively impact access for Veterans and their families in general, especially for those whose health is declining or who cannot drive because of their age. Lack of transportation, problems with transportation services, and lack of public transportation can lead to delays in care. Additionally, the lack of communication with the Veterans Affairs (VA) Health System and with the healthcare team, as well as inefficient communication among the healthcare team, lack of coordination of care between the VA health system and community providers, and the lack of cultural competence of healthcare providers and contracted personnel made access to services even more challenging.
CONCLUSIONS: Improving communication can help to develop a sense of trust between Veterans and the VA, and between Veterans and spouses with the healthcare team. It can also lead to increased patient satisfaction. Ensuring healthcare providers and contracted personnel are culturally competent to talk and treat Veterans can improve patient trust and adherence to treatment. Lastly, resource-related challenges included financial problems, lack of prompt access to appointments, lack of providers, limited access to local clinics and hospitals, limited local programs available, and reimbursement issues.
METHODS: This qualitative study aimed to explore participants\' perceptions of healthcare access. Structured interviews were conducted with 124 Veterans and spouses of Veterans from rural qualifying counties in South Carolina and Florida.
RESULTS: The study\'s results revealed five main dimensions of access: geographic proximity, transportation, communication, cultural competence, and resources. Distance to service needed can negatively impact access for Veterans and their families in general, especially for those whose health is declining or who cannot drive because of their age. Lack of transportation, problems with transportation services, and lack of public transportation can lead to delays in care. Additionally, the lack of communication with the Veterans Affairs (VA) Health System and with the healthcare team, as well as inefficient communication among the healthcare team, lack of coordination of care between the VA health system and community providers, and the lack of cultural competence of healthcare providers and contracted personnel made access to services even more challenging.
CONCLUSIONS: Improving communication can help to develop a sense of trust between Veterans and the VA, and between Veterans and spouses with the healthcare team. It can also lead to increased patient satisfaction. Ensuring healthcare providers and contracted personnel are culturally competent to talk and treat Veterans can improve patient trust and adherence to treatment. Lastly, resource-related challenges included financial problems, lack of prompt access to appointments, lack of providers, limited access to local clinics and hospitals, limited local programs available, and reimbursement issues.
摘要：
背景：对于退伍军人及其家人来说，在农村地区获得身心医疗保健是一项挑战，但对身体健康至关重要。尽管最近的研究揭示了农村退伍军人在获得医疗保健方面面临的一些挑战，对访问差距的完整理解仍不清楚。
方法：这项定性研究旨在探索参与者对医疗服务的认知。对来自南卡罗来纳州和佛罗里达州农村合格县的124名退伍军人和退伍军人配偶进行了结构化访谈。
结果：研究结果揭示了访问的五个主要维度：地理接近度，交通运输,通信,文化能力,和资源。距离所需的服务可能会对退伍军人及其家人的访问产生负面影响，特别是对于那些健康状况下降或由于年龄原因不能开车的人。缺乏交通,运输服务的问题，缺乏公共交通会导致护理延误。此外,缺乏与退伍军人事务（VA）卫生系统和医疗团队的沟通，以及医疗团队之间的低效沟通，VA卫生系统和社区提供者之间缺乏护理协调，医疗保健提供者和签约人员缺乏文化能力，使得获得服务更具挑战性。
结论：改善沟通有助于培养退伍军人和退伍军人之间的信任感，以及退伍军人和医疗团队的配偶之间。它还可以提高患者的满意度。确保医疗保健提供者和签约人员在文化上有能力交谈和治疗退伍军人可以提高患者对治疗的信任度和依从性。最后,与资源相关的挑战包括财务问题，缺乏及时的预约，缺少供应商,进入当地诊所和医院的机会有限，有限的本地程序可用，和报销问题。
方法：这项定性研究旨在探索参与者对医疗服务的认知。对来自南卡罗来纳州和佛罗里达州农村合格县的124名退伍军人和退伍军人配偶进行了结构化访谈。
结果：研究结果揭示了访问的五个主要维度：地理接近度，交通运输,通信,文化能力,和资源。距离所需的服务可能会对退伍军人及其家人的访问产生负面影响，特别是对于那些健康状况下降或由于年龄原因不能开车的人。缺乏交通,运输服务的问题，缺乏公共交通会导致护理延误。此外,缺乏与退伍军人事务（VA）卫生系统和医疗团队的沟通，以及医疗团队之间的低效沟通，VA卫生系统和社区提供者之间缺乏护理协调，医疗保健提供者和签约人员缺乏文化能力，使得获得服务更具挑战性。
结论：改善沟通有助于培养退伍军人和退伍军人之间的信任感，以及退伍军人和医疗团队的配偶之间。它还可以提高患者的满意度。确保医疗保健提供者和签约人员在文化上有能力交谈和治疗退伍军人可以提高患者对治疗的信任度和依从性。最后,与资源相关的挑战包括财务问题，缺乏及时的预约，缺少供应商,进入当地诊所和医院的机会有限，有限的本地程序可用，和报销问题。
