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Poster

Understanding Home Modification Provision in Rural and Urban Areas within the Veterans Health Administration

Wednesday, November 1, 2023
10:00 AM – 10:06 AM  
Location: Station 12

    Presenting Author(s)

  • Jaewon Kang, Ph.D, MSOT

    Postdoctoral Research Associate
    University of Illinois Urbana-Champaign
    Champaign, Illinois, United States

    • Non-presenting Author(s)

  • ML

    Mi jung Lee, PhD

    Assistant Professor
    University of Texas Medical Branch at Galveston
    Texas City, Texas, United States

  • Sergio Romero, PhD

    Co-Director Veterans Rural Health Resource Center
    Veterans Health Administration
    Gainesville, Florida, United States

Research Objectives: To compare home modification provisions within the Veterans Health Administration between rural and urban areas

Design: A retrospective descriptive study

Setting: Veterans Health Administration (VHA) in VA Sunshine Healthcare Network (VISN 8)

Participants: 117,690 Veterans enrolled in the Veterans Health Administration in Florida, South Georgia, Puerto Rico, and the U.S. Virgin Islands during the fiscal year 2019

Interventions: Not applicable

Main Outcome Measures: Not applicable

Results: In fiscal year 2019, 19.7% of enrolled Veterans in VISN 8 (23,170 out of 117,690) received home modifications. There were no differences in percentages between rural and urban Veterans. Rural Veterans who received modifications were younger (mean age 71.1, SD 12.4) but had more health conditions (mean 18.7, SD 9.4) than urban Veterans (mean age 72.2, SD 13.8, the mean number of conditions 17.1, SD 8.9). Common medical conditions among Veterans receiving home modifications included "Essential hypertension" (71.2%), "Disorders of lipid metabolism" (59.8%), "Type 2 Diabetes" (44.3%), "Musculoskeletal pain" (40.4%), and "Low back pain" (37.9%). Rural Veterans had significantly higher rates of these conditions compared to urban Veterans (P <.05). The most ordered equipment for those receiving home modifications were bath or shower chairs (43.6%), bathtub grab bars (29.7%), and tub stools or benches (22.1%). Rural Veterans were less likely to receive them (χ21=12.3, P=.001; χ21=10.8, P=.001; χ21=341.5, P<.001).

Conclusions: This study revealed no differences in access to home modifications across rural and urban locations, highlighting the VA's commitment to equitable access. However, since rural Veterans had a higher number of health conditions, there might be opportunities to provide additional home medications to support them. VA should continue to provide home modification services to help Veterans manage their health in their home environments and maximize function.

Author(s) Disclosures: Authors report no conflicts of interest.

Learning Objectives:

  • Upon completion, participants will be able to compare the health conditions of rural and urban Veterans who received home modifications.
  • Upon completion, participants will be able to identify the most commonly ordered equipment for home modifications, including bath or shower chairs and grab bars, to improve home safety and accessibility.
  • Upon completion, participants will be able to propose strategies for the VA to better support Veterans in managing their independence in their home environments based on the study's findings.