b'The Cincinnati VAMC offers telerehabilitation for veterans with neurodegenerative conditions. Occupational, physical and speech therapy services are offered through telehealth as an alternative to in-person care. Photo from VA press release July 29, 2022Their cohort study involved 63.5 million primaryservices, adding, Few video visits occurred across care and nearly 4 million mental health integrationrural and urban healthcare systems (unadjusted per-visitsacross138VAhealthcaresystemsnationallycentages:beforethepandemic,2%vs.1%;after from March 16, 2019, to Dec. 15, 2021. For everythe pandemic, 4% vs. 8%). Nonetheless, there were system,monthlyvisitcountsfornearly64millionrural-urban divides for video visits in both primary primary care and mental health integration specialtiescare (OR, 0.28; 95% CI, 0.19-0.40) and mental health were aggregated from 12 months before to 21 monthsintegration services (OR, 0.34; 95% CI, 0.21-0.56).after pandemic onset. Researchers categorized visitsThe findings suggested that, even with initial tele-as in person or telemedicine, including video.medicine gains at rural VA healthcare sites, the pan-Participants had a mean age of 61.4 and were 90.5%demic was associated with an increase in the rural-male. The cohort included 66.3% non-Hispanic whiteurban telemedicine divide across the VA healthcare patients and 17.2% non-Hispanic Black patients.system.Toensureequitableaccesstocare,the Results indicated that, in fully adjusted models forVAhealthcaresystemscoordinatedtelemedicine primarycareservicesbeforethepandemic,ruralresponse may benefit from addressing rural dispari-VAhealthcaresystemshadhigherproportionsofties in structural capacity (e.g., internet bandwidth) telemedicineusethanurbanones(34%[95%CI,and from tailoring technology to encourage adoption 30%-38%] vs. 29% [95% CI, 27%-32%]) but loweramong rural users.proportions of telemedicine use than urban health- 1Ferguson JM, Wray CM, Jacobs J, Greene L, e. al. Variation in initial care systems after pandemic onset (55% [95% CI,and continued use of primary, mental health, and specialty video care 50%-59%] vs. 60% [95% CI, 58%-62%]). That rep- among Veterans. Health Serv Res. 2022 Nov 7. doi: 10.1111/1475-resented a 36% reduction in the odds of telemedicine2 6773.14098. Epub ahead of print. PMID: 36345235.use (odds ratio [OR], 0.64; 95% CI, 0.54-0.76), the Leung LB, Yoo C, Chu K, OShea A, Jackson NJ, Heyworth L, Der-Martirosian C. Rates of Primary Care and Integrated Mental researchers noted. Health Telemedicine Visits Between Rural and Urban Veterans Affairs They added that the rural-urban telemedicine gapBeneficiaries Before and After the Onset of the COVID-19 Pandemic. was even larger for mental health integration (OR,JAMA Netw Open. 2023 Mar 1;6(3):e231864. doi: 10.1001/jamanet-0.49;95%CI,0.35-0.67)thanforprimarycareworkopen.2023.1864. PMID: 36881410; PMCID: PMC9993180.56'