title: Using geographic information system tools to improve access to MS specialty care in Veterans Health Administration.
abstract: Access to appropriate and timely healthcare is critical to the overall health and well-being of patients with chronic diseases. In this study, we used geographic information system (GIS) tools to map Veterans Health Administration (VHA) patients with multiple sclerosis (MS) and their access to MS specialty care. We created six travel-time bands around VHA facilities with MS specialty care and calculated the number of VHA patients with MS who resided in each time band and the number of patients who lived more than 2 hours from the nearest specialty clinic in fiscal year 2007. We demonstrate the utility of using GIS tools in decision-making by providing three examples of how patients' access to care is affected when additional specialty clinics are added. The mapping technique used in this study provides a powerful and valuable tool for policy and planning personnel who are evaluating how to address underserved populations and areas within the VHA healthcare system.
authors.affiliation: Multiple Sclerosis Center of Excellence, Department of Veterans Affairs Maryland Healthcare System, Baltimore, MD 21210, USA. William.Culpepper@va.gov
authors.forename: William J
authors.initials: WJ
authors.lastname: Culpepper
authors.forename: Diane
authors.initials: D
authors.lastname: Cowper-Ripley
authors.forename: Eric R
authors.initials: ER
authors.lastname: Litt
authors.forename: Tzu-Yun
authors.initials: TY
authors.lastname: McDowell
authors.forename: Paul M
authors.initials: PM
authors.lastname: Hoffman
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000592:standards; D002908:Chronic Disease; D003695:Delivery of Health Care / Q000458:organization & administration*; D040362:Geographic Information Systems; D006297:Health Services Accessibility / Q000458:organization & administration*; D006782:Hospitals, Special; D006787:Hospitals, Veterans; D006801:Humans; D008511:Medicine / Q000706:statistics & numerical data*; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000534:rehabilitation; D012189:Retrospective Studies; D017748:Time Management / Q000379:methods; D014195:Travel; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration*; D014728:Veterans; D058014:Veterans Health