title: Barriers to home and community-based service referrals: the physician's role.
abstract: The purpose of this study was to obtain information about Department of Veteran Affairs (VA) long-term care (LTC) referrals that could be used to develop interventions that increase the likelihood of referrals to home and community-based services (HCBS) instead of institutional care. This primarily qualitative study was conducted at five VA Medical Centers. The study used three linked methods: interviews with patients and informal caregivers; focus groups with LTC administrators, providers, and social workers; and written rankings of the barriers to HCBS referrals. We unexpectedly identified a cluster of findings indicating the importance of physicians' role in the LTC referral process and the need for more LTC training, particularly about HCBS.
authors.affiliation: Health Services Research and Development Center of Excellence, VA Puget Sound Health Care System, Seattle, Washington 98101, USA. sheri.reder@va.gov
authors.forename: Sheri
authors.initials: S
authors.lastname: Reder
authors.forename: Susan
authors.initials: S
authors.lastname: Hedrick
authors.forename: Marylou
authors.initials: M
authors.lastname: Guihan
authors.forename: Sara
authors.initials: S
authors.lastname: Miller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003153:Community Health Services / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration; D006699:Home Care Services / Q000458:organization & administration; D006707:Homes for the Aged / Q000458:organization & administration; D006801:Humans; D007407:Interviews as Topic; D008134:Long-Term Care / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000458:organization & administration; D010819:Physician's Role; D036301:Qualitative Research; D012017:Referral and Consultation / Q000458:organization & administration*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration