Examining the impact of the veterans affairs community care program on mental healthcare in rural veterans: A qualitative study
通过访谈21名医疗服务提供者和管理者，研究了退伍军人事务部社区护理计划对农村退伍军人急性和住院心理医疗的影响，发现该计划在某些情况下可满足需求，但存在协调和沟通等挑战。
OBJECTIVE: To investigate provider and administrators' perspectives about the impact of the Department of Veterans Affairs' (VA) Community Care program on acute and residential mental health treatment of rural Veterans. DATA SOURCES AND STUDY SETTING: Primary data were collected from participants via interviews. Participants were employees of VA Healthcare Systems located in Northern New England, or employees of non-VA mental health treatment settings affiliated with VA in Northern New England. STUDY DESIGN: This study was informed by the Consolidated Framework for Implementation Research (CFIR), with Community Care as the implemented program. Individual, semi-structured interviews were conducted. DATA COLLECTION/EXTRACTION METHODS: Individual interviews were transcribed, coded deductively using the CFIR, and inductively coded by locating themes. PRINCIPAL FINDINGS: Twenty-one people completed interviews. Commonly reported challenges included community programs not focused on Veterans' needs, poor coordination of care, communication challenges, and problems tracking Veteran care. Facilitators included increased access to care and strengthening coordination of care. CONCLUSIONS: The VA's Community Care program can address the acute or residential mental health needs of Veterans in rural settings in some circumstances, however there are challenges to successful implementation.