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.

KEYWORDS:

• aging
• long-term care
• qualitative research
• access to health care
• health education

This report presents the findings and views of the authors. It does not necessarily represent those of the Veteran's Administration or Health Services Research and Development Service. The research reported here was supported by Department of Veterans Affairs, Health Services Research and Development Project #IIR 02–228.