Access to multiple sclerosis specialty care

Abstract

Background: Health care providers recommend an annual visit to a multiple sclerosis specialty care provider.

Objective: To examine potential barriers to the implementation of this recommendation in the Veterans Health Administration.

Design: Observational cohort study.

Setting: Veterans Health Administration.

Participants: Participants were drawn from the Veterans Affairs Multiple Sclerosis National Data Repository and were included if they had an outpatient visit in 2007 and were alive in 2008 (N = 14,723).

Main outcome measurements: Specialty care visit, receipt of medical services.

Results: A total of 9643 (65.5%) participants had a specialty care visit in 2007. Veterans who were service connected, had greater medical comorbidity, and who lived in urban settings were more likely to have received a specialty care visit. Veterans who were older and had to travel greater distances to a center were less likely to have a specialty care visit.

Conclusions: Access to care in rural areas and areas at a greater distance from a major medical center represent notable barriers to rehabilitation and other multiple sclerosis-related care.