Interorganizational Care Coordination of Rural Veterans by Veterans Affairs and Community Care Programs: A Systematic Review.
Med Care
; 59(Suppl 3): S259-S269, 2021 06 01.
Article
in English
| MEDLINE | ID: covidwho-1225638
ABSTRACT
BACKGROUND:
In the unique context of rural Veterans' health care needs, expansion of US Department of Veterans Affairs and Community Care programs under the MISSION Act, and the uncertainties of coronavirus disease 2019 (COVID-19), it is critical to understand what may support effective interorganizational care coordination for increased access to high-quality care.OBJECTIVES:
We conducted a systematic review to examine the interorganizational care coordination initiatives that Veterans Affairs (VA) and community partners have pursued in caring for rural Veterans, including challenges and opportunities, organizational domains shaping care coordination, and among these, initiatives that improve or impede health care outcomes. RESEARCHDESIGN:
We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to search 2 electronic databases (PubMed and Embase) for peer-reviewed articles published between January 2009 and May 2020. Building on prior research, we conducted a systematic review.RESULTS:
Sixteen articles met our criteria. Each captured a unique health care focus while examining common challenges. Four organizational domains emerged policy and administration, culture, mechanisms, and relational practices. Exemplars highlight how initiatives improve or impede rural health care delivery.CONCLUSIONS:
This is the first systematic review, to our knowledge, examining interorganizational care coordination of rural Veterans by VA and Community Care programs. Results provide exemplars of interorganizational care coordination domains and program effectiveness. It suggests that partners' efforts to align their coordination domains can improve health care, with rurality serving as a critical contextual factor. Findings are important for policies, practices, and research of VA and Community Care partners committed to improving access and health care for rural Veterans.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Quality of Health Care
/
Rural Health Services
/
Continuity of Patient Care
/
Veterans Health Services
/
Health Services Accessibility
Type of study:
Reviews
/
Systematic review/Meta Analysis
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Med Care
Year:
2021
Document Type:
Article
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