Facilitators and barriers to accessing care for Veterans with brain injury: Veterans Affairs provider perspectives

Abstract: Objectives: To identify facilitators and barriers to accessing care for Veterans with brain injury. Design: The study used an access to health care framework, one to guide the development of qualitative research on VA providers’ perceptions of the facilitators and barriers to accessing care for Veterans with brain injury. Setting: Research activities were conducted virtually through Microsoft Teams. Participants: Participants were provider and administrative stakeholders from the Department of Veterans Affairs. Interventions: No intervention was used. Main Outcome Measures: Demographic survey and semistructured qualitative interviews and focus groups. Results: Stakeholders identified organizational factors that facilitated the provision of services for Veterans with brain injuries including access to multidisciplinary teams, organizational partnerships, and interagency consultation. Utilization of community-based resources was also a facilitator to access, highlighting the importance of the relationship between VA and community resources. Stakeholders reported several barriers that could complicate access and engagement in treatment for Veterans seeking care. Barriers included staffing challenges (lack of staff and overburdened staff) within VA systems, wait times for appointments, availability of appointments (hours of operation), transportation for Veterans, and housing or homelessness. Contracting with community-based service providers was perceived as a barrier to providing care for Veterans due to a lack of awareness regarding military culture, a lack of comprehensive integrated care, and a lack of communication between the community provider and VA provider. Conclusions: Findings indicate that despite organizational factors that facilitate access to services for Veterans, some VA systems struggle with having enough staff to ensure quality services and existing staff burden. There is a need to address existing resources within VA systems and further strengthen partnerships with community-based providers.

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