Home Modifications for Rural Veterans With Disabilities.

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Health Services Research

Background:

• Home modifications (HMs) are crucial for fall risk reduction and accessibility, especially for veterans in rural areas or substandard housing.
• The Home Improvements and Structural Alterations (HISA) program provides HMs for veterans with disabilities through the Veterans Health Administration (VHA).

Purpose of the Study:

• To profile rural veteran (RV) users of the HISA program.
• To analyze national HISA utilization patterns, comparing usage across different Veterans Affairs (VA) medical center complexities and regions.
• To examine the relationship between travel time/distance and HISA utilization among rural veterans.

Main Methods:

• Retrospective database study utilizing GeoSpatial analyses.
• Inclusion of data from the National Prosthetics Patient Database, VHA Medical Inpatient Dataset, and VHA Outpatient Dataset.
• Analysis of HISA utilization from 2015-2018.

Main Results:

• 10,810 rural veterans used HISA between 2015-2018, with a mean age of 70.9 years; most were White, married, and male.
• Rural veterans traveled an average of 79.8 miles (94.5 minutes) for HISA prescriptions, with ~25% traveling further, including 43% traveling 100-200 miles.
• Top diagnoses included musculoskeletal (19.1%), neurologic (12.5%), and cardiovascular (5.4%). Bathroom modifications were most frequent (82.4%).

Conclusions:

• This study provides national demographic and clinical data on rural HISA users.
• Findings can inform policymakers, service providers, and HISA administrators for future program planning and resource allocation.
• Understanding rural veteran HISA user profiles is essential for optimizing accessibility and safety in their homes.