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Table 3 Key challenges, barriers and facilitators to expansion of HBPC across 12 VA Medical Centers

From: Barriers and facilitators to implementation of VA home-based primary care on American Indian reservations: a qualitative multi-case study

  VAMC 1 VAMC 2 VAMC 3 VAMC 4 VAMC 5 VAMC 6 VAMC 7 VAMC 8 VAMC 9 VAMC 10 VAMC 11 VAMC 12
CHALLENGES
 Target population eligibility and need for HBPC unknown X X X X X X X X X X X X
 Distance & other rural conditions (e.g., connectivity) X X X X X X X X X X X X
 Hiring: recruitment and delays X X X X   X X   X   X X
 Patients may have co-pay to use HBPC and other VA services   X X X X X X   X X   X
BARRIERS
 Remote areas of reservation too distant      X      X X  
 Potential patients do not meet VHA medical benefit eligibility   X    X        
FACILITATORS
 Established mature HBPC program, standardized outcome measures and local VAMC referral patterns X X X X X X X X X X X X
 Outreach activities to enroll American Indian veterans for VA benefits and/or explain HBPC service X X X X X X X X X X X X
 Seed and sustainment funding for expansion X X X X   X X X X X X X
 Personal characteristics of HBPC program staff   X X   X     X X X X
 American Indian community advocate X X X     X      X
 Formal or informal referral mechanism for HBPC referral with IHS/THP   X    X   X   X    X