Outpatient Cardiovascular Disease Consultation Wait Times in the United States-Mexico Border Regions

Access to timely healthcare in disadvantaged areas remains essential to achieving equitable health outcomes, especially in regions facing structural and social vulnerabilities. We evaluated assessment wait times for cardiovascular disease consultations in USMexico border regions compared to non-border regions among US Veterans.

This longitudinal panel of counties included all cardiovascular consultations referred from the U.S. Veterans Health Administration to community medical centers from 2014 to 2020. Consultations were classified as either a US-Mexico border or a non-border region based on the Veterans' home addresses. Multivariable linear regression analyses were performed to evaluate the impact of border status on average wait times. ARIMA modeling was completed to estimate forecasted wait times during the COVID-19 pandemic. The primary outcomes were the average wait times in days for consultation scheduling, completion, and total wait time from approval to consultation completion.

Wait times for cardiovascular disease consultations were not higher in US-Mexico border counties than in non-border regions. For electrophysiology consultations specifically, border counties exhibited significantly shorter total wait times (coeff = -10.81 days, p=0.008). Additionally, while the COVID-19 pandemic led to increased total wait times in non-border areas (actual=42.49 days versus predicted=28.47 days), total wait times in border regions remained stable during this period.

US-Mexico border region status does not appear to result in longer wait times for cardiovascular disease consultations, with the exception of shorter wait times for electrophysiology services. These findings suggest that wait times are not a primary barrier within the VHA community care system in border areas.