Date of Conferral

2023

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Miriam Ross

Abstract

Veterans often have difficulty accessing health care within the Veterans Affairs (VA) system, contributing to the growing need for health care services in rural communities. The increasing demand for health care services in rural communities is driven by the aging population, an increase in life expectancy, and an increase in chronic disease. This quantitative study aimed to explore the relationship between the type of appointment and patient location on initial primary care and telehealth primary care wait times for veterans in West Virginia. The two research questions addressed the independent variables, type of appointment (telehealth or face to face) and patient location (urban vs. rural), and the impact, if any, on the dependent variables, initial primary care and telehealth primary care wait time. The independent t test and the Mann-Whitney U test analyzed the data. Secondary data were obtained from VA Informatics and Computing Infrastructure. Donabedian's 1966 framework on structural, process, and outcomes standards applies to access to care and provided the theoretical framework for this quantitative study. Analyses indicated a significant relationship between the type of appointment and the average wait time, as well as patient location and type of appointment. The F2F initial primary care visits were higher than telehealth conducted via telephone visits, and the average wait time was lower in the F2F visits than in those conducted via telehealth/telephone. Also, the wait times were higher for rural patients than for urban patients. The results of this study may lead to positive social change by contributing to a more focused allocation of health care resources through considerations of innovative telehealth services in rural communities.

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