• Aaron P Turner, Michael K Chapko, David Yanez, Steve L Leipertz, Alicia P Sloan, Ruth H Whitham, and Jodie K Haselkorn.
• Department of Rehabilitation Medicine, Veterans Affairs Puget Sound Health Care System, S-117-RCS, 1660 S Columbian Way, Seattle, WA 98108; Multiple Sclerosis Center of Excellence West, Veterans Affairs, Seattle, WA; Department of Physical Medicine and Rehabilitation, University of Washington, Seattle, WA(∗). Electronic address: Aaron.Turner@va.gov.
• PM R. 2013 Dec 1; 5 (12): 1044-50.

BackgroundHealth care providers recommend an annual visit to a multiple sclerosis specialty care provider.ObjectiveTo examine potential barriers to the implementation of this recommendation in the Veterans Health Administration.DesignObservational cohort study.SettingVeterans Health Administration.ParticipantsParticipants 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 MeasurementsSpecialty care visit, receipt of medical services.ResultsA 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.ConclusionsAccess 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.Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

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