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. 2021 Jun 1;59(Suppl 3):S259-S269.
doi: 10.1097/MLR.0000000000001542.

Interorganizational Care Coordination of Rural Veterans by Veterans Affairs and Community Care Programs: A Systematic Review

Lynn A Garvin  1   2 , Marianne Pugatch  1   3 , Deborah Gurewich  1   4 , Jacquelyn N Pendergast  1 , Christopher J Miller  1   5
Affiliations

Interorganizational Care Coordination of Rural Veterans by Veterans Affairs and Community Care Programs: A Systematic Review

Lynn A Garvin et al. Med Care. .

Abstract

Background: In the unique context of rural Veterans' health care needs, expansion of US Department of Veterans Affairs and Community Care programs under the MISSION Act, and the uncertainties of coronavirus disease 2019 (COVID-19), it is critical to understand what may support effective interorganizational care coordination for increased access to high-quality care.

Objectives: We conducted a systematic review to examine the interorganizational care coordination initiatives that Veterans Affairs (VA) and community partners have pursued in caring for rural Veterans, including challenges and opportunities, organizational domains shaping care coordination, and among these, initiatives that improve or impede health care outcomes.

Research design: We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to search 2 electronic databases (PubMed and Embase) for peer-reviewed articles published between January 2009 and May 2020. Building on prior research, we conducted a systematic review.

Results: Sixteen articles met our criteria. Each captured a unique health care focus while examining common challenges. Four organizational domains emerged: policy and administration, culture, mechanisms, and relational practices. Exemplars highlight how initiatives improve or impede rural health care delivery.

Conclusions: This is the first systematic review, to our knowledge, examining interorganizational care coordination of rural Veterans by VA and Community Care programs. Results provide exemplars of interorganizational care coordination domains and program effectiveness. It suggests that partners' efforts to align their coordination domains can improve health care, with rurality serving as a critical contextual factor. Findings are important for policies, practices, and research of VA and Community Care partners committed to improving access and health care for rural Veterans.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram of the study selection process. VA indicates Veterans Affairs.
See this image and copyright information in PMC

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References

    1. United States Congress House of Representatives. 113th Congress 2nd Session. H.R. 3230. Veterans Access, Choice, and Accountability Act of 2014. [Became Public Law No: 113-146]; 2014.
    1. House Committee on Veterans’ Affairs. The VA MISSION Act of 2018 (VA Maintaining Systems and Strengthening Integrated Outside Networks Act); 2018.
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