Increasing access to orthotic and prosthetic care in rural communities: Satisfaction with the Department of Veterans Affairs Mobile Prosthetic and Orthotic Care Program

IF 2.7 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of Rural Health Pub Date : 2025-07-11 DOI:10.1111/jrh.70050

Chelsea Leonard , William Feser , Lauren McKown , Emily Whitfield , George E. Kaufman , Daniel Abrahamson , Jessica Young

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引用次数: 0

Abstract

Background

In the Veteran's Health Administration (VHA), rural Veterans who need orthotic and prosthetic (O&P) care typically travel to urban VHA medical centers (VAMCs). This presents a barrier to receiving O&P care, as travel may be burdensome due to medical or psychosocial issues. The VHA Mobile Prosthetic and Orthotic Care Program (MoPOC) removes access barriers to VHA O&P care by providing care in rural VHA clinics or in Veterans’ homes. The goal of this evaluation was to understand if Veterans are satisfied with access to MoPOC care, MoPOC clinicians, and impacts of care.

Methods

We conducted a convergent mixed methods evaluation with a satisfaction survey and qualitative interviews among Veterans who received MoPOC care. Surveys were analyzed descriptively. Interviews were analyzed using rapid matrix analysis.

Results

We received 598 survey responses (36% response rate) from six MoPOC sites and conducted 35 interviews. Findings included high Veteran satisfaction with MoPOC clinicians, high satisfaction with MoPOC care, improved access to care, allowing Veterans to stay in the VHA for care, positive impacts on quality of life, and challenges related to timeliness of device delivery.

Discussion/significance

Veterans were satisfied with MoPOC and MoPOC increased access to care. Many Veterans reported that they would not have received O&P care without MoPOC. This, along with the perceived quality of life impacts, indicates that expanding access to VHA O&P care in rural areas benefits Veterans. Many Veterans preferred to receive care in the VHA, suggesting programs like MoPOC are preferable to outsourcing care to non-VHA settings. Ensuring timeliness of device delivery is a key challenge, and it is unknown how satisfaction of timeliness within the VHA compares to satisfaction with timeliness of device provision in other settings.

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在农村社区增加矫形器和矫形器护理：对退伍军人事务部移动矫形器和矫形器护理计划的满意度

在退伍军人健康管理局（VHA）中，需要矫形和假肢（O&；P）护理的农村退伍军人通常前往城市VHA医疗中心（VAMCs）。这对接受o&p护理构成障碍，因为由于医疗或社会心理问题，旅行可能会带来负担。VHA移动假肢和矫形护理项目（MoPOC）通过在农村VHA诊所或退伍军人家中提供护理，消除了VHA o&p护理的准入障碍。本评估的目的是了解退伍军人是否对获得MoPOC护理、MoPOC临床医生和护理的影响感到满意。方法采用满意度调查和定性访谈相结合的融合混合方法对接受MoPOC护理的退伍军人进行评价。对调查进行描述性分析。访谈采用快速矩阵分析进行分析。结果共收到598份问卷，回复率36%，共进行了35次访谈。研究结果包括退伍军人对MoPOC临床医生的高满意度，对MoPOC护理的高满意度，改善护理的可及性，允许退伍军人留在VHA接受护理，对生活质量的积极影响，以及与设备交付及时性相关的挑战。讨论/意义退伍军人对MoPOC感到满意，MoPOC增加了获得护理的机会。许多退伍军人报告说，如果没有MoPOC，他们就不会得到o&p护理。这一点，再加上对生活质量的影响，表明在农村地区扩大获得VHA o&p护理的机会有利于退伍军人。许多退伍军人更愿意在VHA接受护理，这表明像MoPOC这样的项目比将护理外包给非VHA机构更可取。确保设备交付的及时性是一项关键挑战，目前尚不清楚VHA内的及时性满意度与其他设置中设备提供的及时性满意度相比如何。

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来源期刊

Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

6.10%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Rural Health, a quarterly journal published by the NRHA, offers a variety of original research relevant and important to rural health. Some examples include evaluations, case studies, and analyses related to health status and behavior, as well as to health work force, policy and access issues. Quantitative, qualitative and mixed methods studies are welcome. Highest priority is given to manuscripts that reflect scholarly quality, demonstrate methodological rigor, and emphasize practical implications. The journal also publishes articles with an international rural health perspective, commentaries, book reviews and letters.