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PURPOSE The Veterans Health Administration (VHA) devised an algorithm to classify veterans as Urban, Rural, or Highly Rural residents. To understand the policy implications of the VHA scheme, we compared its categories to 3 Office of Management and Budget (OMB) and 4 Rural-Urban Commuting Area (RUCA) geographical categories. METHOD Using residence(More)
CONTEXT The Veterans Health Administration (VA) provides comprehensive health care services to veterans across the United States. Recently, the VA established an Office of Rural Health to address the health care needs of rural veterans. PURPOSE To review the literature on rural veterans' health care needs in order to identify areas for future research. (More)
OBJECTIVE The authors examined the efficacy of methylphenidate in the treatment of depression in a group of older, medically ill patients. METHOD Sixteen patients underwent an 8-day double-blind, randomized, placebo-controlled crossover trial; 13 completed the trial. RESULTS Statistically and clinically significant treatment responses were found. (More)
This study surveyed 189 women physicians in order to compare the experiences of those who had male mentors with those who had female mentors. Respondents with high-ranking male mentors reported more career sponsorship. However, those with lower ranking female mentors reported more personal advice. In addition, those with female mentors reported fewer(More)
CONTEXT The 4.5 million military veterans treated by the Veterans Health Administration (VA) are believed to experience poorer physical and mental health than nonveterans. Furthermore, nonmetropolitan residents have less access to medical services, whether or not they are veterans in VA care. A direct comparison of metropolitan and nonmetropolitan veterans(More)
Two scales developed to assess combat exposure and posttraumatic stress disorder symptomatology in Vietnam veterans displayed very high reliability. High levels of posttraumatic stress disorder were associated with more current life stresses and other standardized indices of dysphoria.
Previous research has demonstrated a reduction in utilization of medical services following the initiation of psychiatric services for certain patients. The phenomenon has been called the offset effect. The authors investigated the offset effect in a Veterans Administration medical center setting. They found that the offset effect emerged only for patients(More)
CONTEXT Cross-sectional studies have identified rural-urban disparities in veterans' health-related quality-of-life (HRQOL) scores. PURPOSE To determine whether longitudinal analyses confirmed that these disparities in veterans' HRQOL scores persisted. METHODS We obtained data from the SF-12 portion of the veterans health administration's (VA's) Survey(More)
CONTEXT Unplanned readmission within 30 days of discharge is an indicator of hospital quality. PURPOSE We wanted to determine whether older rural veterans who were enrolled in the VA had different rates of unplanned readmission to VA or non-VA hospitals than their urban counterparts. METHODS We used the combined VA/Medicare dataset to examine 3,513,912(More)
OBJECTIVE To compare Veterans Health Administration (VA) patients, non-VA-using veterans, and nonveterans, separated by urban/rural residence and age group, on their use of major categories of medical care and payment sources. DATA SOURCE Expenditures for health care-using men in Medical Expenditure Panel Surveys from 1996 through 2004. STUDY DESIGN(More)