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Related Concept Videos

Documentation in Long-Term and Home Healthcare Setting01:29

Documentation in Long-Term and Home Healthcare Setting

Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
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Specialized Care Centers and Settings-II01:30

Specialized Care Centers and Settings-II

Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Community Based Intervention01:30

Community Based Intervention

Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Specialized Care Centers and Settings-I01:30

Specialized Care Centers and Settings-I

Specialized care settings or centers are situated in convenient locations within the community and offer care to a specific group or population. They consist of daycare facilities, mental health facilities, rural health facilities, educational institutions, industries, shelters for the homeless, and rehabilitation facilities.
Daycare centers
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Homeostatic Imbalance01:10

Homeostatic Imbalance

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Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
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Updated: Jun 12, 2026

Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data
11:21

Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data

Published on: July 27, 2018

Rural-Urban Variability in Home and Community-Based Service Use Among Veterans.

Heather Davila1,2,3, Daniel Hackert4, Frank DeVone4

  • 1Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa, USA.

Journal of the American Geriatrics Society
|June 10, 2026
PubMed
Summary
This summary is machine-generated.

Rural Veterans use fewer home and community-based services (HCBS) than urban Veterans, but facility-level variations exist. Some Veterans Affairs Medical Centers (VAMCs) successfully provide HCBS to rural Veterans at rates comparable to urban populations.

Keywords:
access to careaginghome and community‐based servicesrural healthcare

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Area of Science:

  • Health Services Research
  • Rural Health
  • Gerontology

Background:

  • Home and Community-Based Services (HCBS) are crucial for enabling individuals to age in place, yet rural access may be limited.
  • Understanding rural-urban disparities in HCBS utilization among Veterans is essential for equitable care delivery.

Purpose of the Study:

  • To investigate differences in HCBS use between rural and urban Veterans within the Veterans Health Administration (VHA).
  • To identify variations in HCBS utilization at the facility level.

Main Methods:

  • A cross-sectional study analyzed fiscal year 2022 VHA data.
  • Veteran rurality was determined using Rural-Urban Area Commuting Codes; HCBS use was identified via VHA payment files.
  • Regression analyses adjusted for demographics, comorbidities, Area Deprivation Index (ADI), and facility fixed effects.

Main Results:

  • Rural Veterans (34.1%) were more likely to be older, male, and white compared to urban counterparts.
  • Overall, rural Veterans had a slightly lower adjusted risk ratio (0.92) for HCBS use compared to urban Veterans.
  • Significant facility-level variability was observed, with rural Veterans' HCBS use ranging from 60% less likely to 167% more likely than urban Veterans.

Conclusions:

  • Rural Veterans utilized HCBS less frequently overall, highlighting a persistent disparity.
  • Substantial variation across Veterans Affairs Medical Centers (VAMCs) indicates that systemic factors influence HCBS access for rural Veterans.
  • Targeted interventions at specific VAMCs can mitigate disparities and improve HCBS access for rural Veterans.