ERIC Number: EJ878668
Record Type: Journal
Publication Date: 2010
Abstractor: As Provided
Reference Count: 43
A Longitudinal Analysis of Rural and Urban Veterans' Health-Related Quality of Life
Wallace, Amy E.; Lee, Richard; MacKenzie, Todd A.; West, Alan N.; Wright, Steven; Booth, Brenda M.; Hawthorne, Kara; Weeks, William B.
Journal of Rural Health, v26 n2 p156-163 Spr 2010
Context: Cross-sectional studies have identified rural-urban disparities in veterans' health-related quality-of-life (HRQOL) scores. Purpose: To determine whether longitudinal analyses confirmed that these disparities in veterans' HRQOL scores persisted. Methods: We obtained data from the SF-12 portion of the veterans health administration's (VA's) Survey of Healthcare Experiences of Patients (SHEP) collected between 2002 and 2006. During that time, the SHEP was randomly administered to approximately 250,000 veterans annually who had used VA outpatient services. We evaluated 163,709 responses from veterans who had completed 2 or more surveys during the years studied. Respondents were classified into rural-urban groups using ZIP Code-based rural-urban commuting area designations. We estimated linear regression models using generalized estimating equations to determine whether rural and urban veterans' HRQOL scores were changing at different rates over the time period examined. Findings: After adjustment for sociodemographic differences, we found that urban veterans had substantially better physical HRQOL scores than their rural counterparts and that these differences persisted over the study period. While urban veterans had worse mental HRQOL scores than rural veterans, those differences diminished over the time period studied. Conclusions: Rural-urban disparities in HRQOL scores persist when tracking veterans longitudinally. Reduced access among rural veterans to care may contribute to these disparities. Because rural soldiers are overrepresented in current conflicts, the VA should consider new models of care delivery to improve access to care for rural veterans.
Descriptors: Quality of Life, Rural Urban Differences, Regression (Statistics), Veterans, Longitudinal Studies, Scores, Measures (Individuals), Medical Services, Adults, Patients, Rural Areas, Urban Areas, Barriers, At Risk Persons, Access to Health Care, Mental Health, Physical Health
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Publication Type: Journal Articles; Reports - Research
Education Level: N/A
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