Best Practices for Mission Applications

Rurality: Implications of Its Definition for Healthcare Planning

—Chase Gatlin, Veterans Health Administration

The Veterans Health Administration (VHA) has initiated a number of high profile programs to improve veteran access to its services in rural areas. Yet a basic question remains: What is "rural"? There are at least 16 definitions of rurality used by various agencies of the federal government. The VHA has its own definition. In this presentation we will explain the VHA URH system, present maps of the VHA urban, rural and highly rural areas, and show how access to care statistics, based on drive time to nearest primary care site, differ between these rurality levels. We will show how the Rural-Urban Commuting Area system (RUCA) has been applied to the geocoded address locations of our 8.5 million healthcare system enrollees. Finally we will demonstrate the differences in access statistics between our URH system and the RUCA system.