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Integrating Physical Therapy into Primary Care to Enhance Veteran Access to Healthcare: Findings from the Veterans
Lauren D Stevenson1, Juliana G Barnard2,3, Krysttel C Stryczek2
1VA Health Systems Research, Center of Innovation for Veteran-Centered and Value Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA. lauren.stevenson@va.gov.
Background:
The integration of physical therapy (PT) into primary care has shown significant benefits in patient outcomes and healthcare efficiency. Veterans suffering from chronic musculoskeletal (MSK) pain, mobility, or vestibular issues often face challenges in accessing non-pharmaceutical treatments. Previous studies have indicated that early access to PT can lead to better outcomes, higher patient satisfaction, and cost savings.
Objective:
This evaluation was conducted in collaboration with the Veterans Health Administration (VHA) operational partners to assess the implementation and effectiveness of integrating PT into Patient Aligned Care Teams (PACT) within VHA system (PACT-PT). Qualitative data from Veterans and VHA staff was collected through interviews and analyzed using a Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework focused on program adoption, implementation, and sustainability.
Design:
Purposive sampling identified Veterans (n = 29) and VHA staff (n = 33) for semi-structured interviews from July 2023 through September 2024. Interviews, guided by The Consolidated Framework for Implementation Research (CFIR) and RE-AIM frameworks, focused on program implementation, facilitators/barriers, and PT care access. In-depth content analysis using inductive and deductive coding was conducted with Atlas.ti software.
Key Results:
Veterans and staff reported increased access to PT care, reduced wait times, and less transportation required to receive PT services. PACT-PT allowed Veterans to try conservative musculoskeletal interventions before considering surgery and enabled continuation of VHA care without community referrals, particularly in rural areas where PT may be further from home. Primary care providers perceived lighter workloads and higher job satisfaction. Veterans reported high satisfaction with PACT-PT timeliness, comparing it favorably to traditional PT with fewer barriers.
Conclusion:
PACT-PT is an innovative alternative to traditional PT models. PACT-PT reduces access barriers by integrating PT in local clinics where Veterans receive primary care, reduces the burden of transportation, and improves care coordination within the VHA to improve Veteran health outcomes and well-being.
Clinical Trial Number:
Not applicable.
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