Access to Care and Services Among U.S. Rural Veterans With and Without Disabilities: A National Study

Area of Science:

• Health Services Research
• Rural Health
• Veterans Affairs

Background:

• Access to healthcare presents significant challenges for rural veterans, particularly those with chronic conditions.
• Limited research exists on the specific barriers faced by this population.
• Understanding and addressing these barriers is crucial for improving veteran health outcomes.

Purpose of the Study:

• To develop and validate the Rural Access to Care and Services Scale (RACSS) for assessing physical, mental, and social care access.
• To investigate if minority veterans encounter greater healthcare access barriers.
• To determine the association between RACSS scores and psychosocial outcomes.

Main Methods:

• Data collected from 500 rural U.S. veterans via surveys on demographics, disability, conditions, and healthcare access.
• RACSS developed and validated using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA).
• Internal consistency assessed with Cronbach's alpha; independent sample t-tests explored minority status and access relationships.

Main Results:

• The RACSS demonstrated a robust one-factor structure with excellent model fit and high internal consistency (α = 0.89).
• Veterans from minoritized racial and ethnic groups reported significantly greater difficulties accessing healthcare and services.
• The scale provides a reliable measure for assessing healthcare access in rural veteran populations.

Conclusions:

• The RACCS is a validated and reliable tool for measuring healthcare and service access among rural veterans.
• Findings underscore the urgent need for targeted interventions to improve access for minoritized rural veterans.
• Enhancing rural healthcare delivery is essential for reducing health disparities and improving outcomes for underserved veterans.