Bridging Gaps in Acute Care Access for Rural Veterans
The Reach and Impact of VA's Virtual Emergency and Urgent Care Programs
Bibliographic Data
| ID | 24020552 |
|---|---|
| Authors | Anita Vashi (0000-0002-6305-6779, University of California, San Francisco, corresponding author), Linda Tran (0000-0002-7356-2878, Veterans Health Administration), Linda Diem Tran (Department of Veterans Affairs Health Economics Resource Center Menlo Park California USA), Tracy Urech (0000-0001-6512-3480, VA Palo Alto Health Care System), Allison Engstrom Buggaveeti (VA Palo Alto Health Care System), Liam Rose (0000-0001-7195-2939, Veterans Health Administration) |
| Year | 2026 |
| Volume | 42 |
| Issue | 3 |
| Pages | e70197-e70197 |
| Publication date | 2026-06-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | The Journal of Rural Health (JOURNAL) |
| Journal identifiers | ISSN: 0890-765X • E-ISSN: 1748-0361 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/jrh.70197 |
| PMID | 42569843 |
| OpenAlex | W7201950328 |
| Language | EN |
| References cited | 25 |
Purpose To evaluate the impact of the Veterans Health Administration's (VA) virtual acute care programs—tele‐emergency care (TEC) and virtual care visits (VCV)—on short‐term utilization, mortality, and costs among rural veterans. Methods This retrospective study used national call center data (January 2022–September 2024) linked with VA administrative and community care records. Completed TEC or VCV encounters were grouped by triage acuity: acute (recommended follow‐up within 8 h; n = 61,408) and non‐acute (>8 h; n = 66,319), and compared with matched controls using propensity‐score methods. Primary outcomes were emergency department (ED) visits, hospital admissions, and 30‐day mortality. Secondary outcomes included total, inpatient, outpatient, pharmacy, and community care costs. Findings Among 631,437 nurse triage calls from rural veterans, virtual care was associated with significantly lower ED visits (acute: −11.87 percentage points (pp), 95% CI −12.47 to −11.26; non‐acute: −3.62 pp, 95% CI −4.02 to −3.22) and hospitalizations (acute: −0.55 pp; non‐acute: −0.15 pp). Thirty‐day mortality did not differ significantly in either group. Total costs were modestly higher in both groups that received virtual care (acute: +$549; non‐acute: +$386), driven by outpatient spending and partially offset by lower community care costs. Conclusions Virtual acute care substantially reduced short‐term emergency and hospital utilization among rural veterans across both acuity groups but was associated with higher total 30‐day costs. These findings highlight the potential of embedded virtual programs to improve access for rural veterans, while underscoring the need to evaluate their long‐term value and return on investment.
Acute care · Ambulatory care · Bridging (networking) · Emergency department · Health care · Rural area · Rural community · Telemedicine · Triage · Emergency and Acute Care Studies · Telemedicine and Telehealth Implementation · Trauma and Emergency Care Studies
| Highly cited | No |
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