Echocardiogram utilization among rural and urban veterans

Area of Science:

• Cardiology
• Health Services Research
• Rural Health

Background:

• Echocardiography is a vital diagnostic tool for cardiovascular conditions.
• Understanding healthcare access disparities for veterans in different geographic locations is crucial.

Purpose of the Study:

• To compare echocardiography utilization between urban and rural veterans.
• To determine if distance to facilities explains any observed differences in utilization.

Main Methods:

• Utilized Veterans Administration administrative data (1999-2007).
• Categorized veterans into urban, rural, and highly rural areas using RUCA codes.
• Employed Poisson regression to analyze echocardiography utilization rates, adjusting for demographics, comorbidities, network clustering, and distance.

Main Results:

• Included over 22.7 million veterans; 1.3 million (5.7%) received echocardiography.
• Initially, utilization was modestly lower in rural and highly rural veterans.
• After adjusting for distance, utilization was slightly higher in highly rural and rural veterans compared to urban veterans.

Conclusions:

• Echocardiography utilization shows only marginal differences between urban and rural veterans.
• The greater distance to echocardiogram facilities for rural veterans accounts for the observed utilization disparities.