Access to multiple sclerosis specialty care

Background: Health care providers recommend an annual visit to a multiple sclerosis specialty care provider. Objective: To examine potential barriers to the implementation of this recommendation in the Veterans Health Administration. Design: Observational cohort study. Setting: Veterans Health Administration. Participants: Participants were drawn from the Veterans Affairs Multiple Sclerosis National Data Repository and were included if they had an outpatient visit in 2007 and were alive in 2008 (N= 14,723). Main Outcome Measurements: Specialty care visit, receipt of medical services. Results: A total of 9643 (65.5%) participants had a specialty care visit in 2007. Veterans who were service connected, had greater medical comorbidity, and who lived in urban settings were more likely to have received a specialty care visit. Veterans who were older and had to travel greater distances to a center were less likely to have a specialty care visit. Conclusions: Access to care in rural areas and areas at a greater distance from a majormedical center represent notable barriers to rehabilitation and other multiple sclerosis-related care.