National Structural Survey of Veterans Affairs Home-Based Primary Care Programs

Area of Science:

• Geriatric Medicine
• Health Services Research
• Veterans Health Administration

Background:

• The Department of Veterans Affairs Home-Based Primary Care (HBPC) program aims to provide comprehensive primary care to veterans in their homes.
• Understanding the current characteristics of HBPC sites is crucial for evaluating program effectiveness and identifying areas for improvement.

Purpose of the Study:

• To describe the current structural and practice characteristics of the Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) program.

Main Methods:

• A national survey was designed and administered online to HBPC program directors.
• Data were collected from 236 HBPC sites, representing a 60% response rate.
• Site characteristics were quantified using closed-ended survey formats.

Main Results:

• HBPC programs primarily serve veterans with complex chronic illnesses at high risk for hospitalization.
• Interdisciplinary teams, including nurses, social workers, and dietitians, are utilized in over 90% of sites.
• Nurse practitioners often serve as principal primary care providers, with variations in site structure, location, and care models observed.

Conclusions:

• HBPC sites align with their mission by focusing on complex chronic illnesses and utilizing interdisciplinary teams for home-based veterans.
• Further research is needed to examine how structural characteristics and care models influence care processes and outcomes.
• Identifying optimal HBPC structures and care models may enhance services for veterans.