Utilization of whole health services among veterans with spinal cord injuries and disorders (SCI/D): Early insights from the VA SCI/D system of care

The Journal of Spinal Cord Medicine, 2024 · DOI: 10.1080/10790268.2023.2183325 · Published: January 1, 2024

Simple Explanation

The Veterans Health Administration (VHA) is transforming its healthcare delivery to adopt a Whole Health approach, which prioritizes holistic, patient-centered care addressing values, goals, and preferences alongside health conditions. The Whole Health model empowers, equips, and treats Veterans through personalized health plans, well-being programs, and clinical care, aiming to improve healthcare quality, especially for those with complex conditions like spinal cord injuries and disorders (SCI/D). This study examines early participation in Whole Health programs among Veterans with SCI/D within the VHA SCI/D system, noting increased utilization but highlighting the need for targeted efforts to expand program reach and understand effective implementation strategies.

Study Duration

3 Years

Participants

Veterans with SCI/D

Evidence Level

Retrospective analysis

Key Findings

1
Utilization of Whole Health Pathway and well-being Programs increased from 62 encounters to 1703 encounters between FY2017 and FY2019.
2
Utilization of chiropractic care rose from 130 encounters to 418 encounters during the same time period.
3
Complementary and integrative health programs increased from 886 encounters to 2655 encounters (representing 1.09% to 3.11% of Veterans; FY2017 to 2019).

Research Summary

This study describes the early trends in Whole Health program utilization among Veterans with SCI/D within the VHA SCI/D System of Care, revealing an overall increase in program use from FY2017 to FY2019. Despite the increasing trend, the absolute utilization rates remain low, suggesting a need for targeted implementation efforts and further research into barriers and facilitators of Whole Health adoption in this population. The VHA SCI/D System of Care employs strategies such as clinical champions and learning collaboratives to support Whole Health implementation, with a comprehensive workload tracking program for monitoring progress.

Practical Implications

Program Adaptation

Adapt Whole Health programs for use by individuals with disabilities to improve accessibility.

Virtual Care Expansion

Expand pilot programs that utilize virtual care methods to increase access and reach.

Targeted Implementation

Implement targeted efforts to increase Whole Health program reach for Veterans with SCI/D.

Study Limitations

1
The structure of the tracking mechanisms that were used are limited by the available Whole Health and CIH clinic codes and CHAR4 workload codes, creating the potential for coding errors.
2
The data available for this analysis was limited, and does not address potential changes in utilization that may have resulted from the COVID-19 pandemic.
3
Our data does not provide insight about the reasons behind observed utilization, including the influence of temporal trends.

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