TABLE 2.

Adjusted Consult Wait Time Measures Across Rural/Urban Strata, Service Types, and Care Settings During FY15† and FY18†

Number of Cases and Service Type	Overall	Rural	Urban	Effect Sizes and P Values	RCC‡	RVA§	Effect Sizes and P Values	UCC∥	UVA¶	Effect Sizes and P Values
No. cases
FY15 number of new patient consult	536,995	178,785	358,210		36,704	142,081		41,846	316,364
FY18 number of new patient consult	691,475	233,271	458,204		69,951	163,320		86,711	371,493
FY15 number of Veterans	489,334	163,789	325,536		35,669	131,471		41,037	289,119
FY18 number of Veterans	617,323	209,008	408,315		66,880	149,930		83,549	337,084
	Overall	Rural	Urban	Effect Size#	RCC	Mean	Effect Size††	UCC	UVA	Effect Size††
Mean waiting time and effect size (or P)
FY15
Service type
Physical therapy	29.52	28.14	30.41	0.121	28.53	28.01	0.028	28.94	30.62	0.089
Cardiology	26.47	26.47	26.90	−0.001	28.20	26.20	0.101	28.46	26.77	0.085
Optometry	42.87	43.02	42.61	0.001	42.94	43.07	0.005	41.85	42.84	0.037
Orthopedic	35.47	35.59	35.51	0.000	35.25	35.67	0.018	37.35	35.26	0.088
Dental	26.21	26.91	27.02	0.000	27.25	26.57	0.030	25.99	27.70	−0.071
FY18
Service type
Physical therapy	26.05	24.48	26.58	0.007	26.32	23.85	0.148	28.84	26.26	0.148
Cardiology	24.87	25.34	24.41	0.003	27.33	25.03	0.121	27.55	24.15	0.183
Optometry	35.36	35.46	34.92	0.001	36.57	34.81	0.069	36.90	34.32	0.102
Orthopedic	29	29.89	28.35	0.004	33.00	29.14	0.194	32.87	27.73	0.262
Dental	25.83	26.08	24.77	0.002	27.34	24.77	0.110	25.90	24.01	0.082
				P ‡‡			P			P
FY15−FY18 difference (% decline FY15−FY18)
Service type
Physical therapy	0.12	3.67 (13)	3.83 (13)	0.046	2.21 (8)	4.17 (15)	<0.001***	0.1 (0)	4.36 (14)	<0.001***
Cardiology	0.06	1.13 (4.28)	2.48 (9)	<0.001***	0.87 (3)	1.17 (4)	0.186	0.91 (3)	2.61 (10)	<0.001***
Optometry	0.18	7.57 (18)	7.69 (18)	0.1	6.36 (15)	8.27 (19)	<0.001***	4.95 (12)	8.52 (20)	<0.001***
Orthopedic	0.18	5.7 (16)	7.16 (20)	<0.001***	2.25 (6)	6.53 (18)	<0.001***	4.48 (12)	7.53 (21)	<0.001***
Dental	0.01	0.83 (3)	2.25 (8)	<0.001***	−0.1 (0)	1.8 (7)	<0.001***	0.09 (0)	3.69 (13)	<0.001***
	Overall	Rural	Urban	Effect Size#	RCC	RVA	Effect Size††	UCC	UVA	Effect Size#
Probability of waiting >30 d and effect size (or P)
FY15
Service type
Physical therapy	0.42	0.38	0.43	0.105	0.39	0.38	0.015	0.39	0.44	0.091
Cardiology	0.36	0.35	0.37	0.027	0.39	0.35	0.087	0.40	0.36	0.069
Optometry	0.6	0.61	0.60	0.015	0.60	0.61	0.011	0.59	0.60	0.027
Orthopedic	0.51	0.52	0.51	0.021	0.51	0.52	0.020	0.55	0.50	0.101
Dental	0.34	0.34	0.34	0.001	0.34	0.34	0.008	0.32	0.36	0.069
FY18
Service type
Physical therapy	0.34	0.30	0.36	0.123	0.32	0.30	0.041	0.37	0.36	0.033
Cardiology	0.32	0.34	0.31	0.049	0.37	0.33	0.075	0.37	0.31	0.125
Optometry	0.49	0.49	0.48	0.031	0.51	0.48	0.063	0.53	0.46	0.139
Orthopedic	0.41	0.42	0.39	0.065	0.48	0.41	0.130	0.47	0.38	0.189
Dental	0.3	0.32	0.29	0.062	0.33	0.30	0.065	0.30	0.28	0.030
FY15−FY18 difference (% decline FY15−FY18)
Service type				P			P			P
Physical therapy	0.07	0.08 (21)	0.07 (17)	0.04*	0.07 (18)	0.08 (21)	0.05*	0.02 (5)	0.08 (18)	<0.001***
Cardiology	0.04	0.02 (5)	0.05 (15)	<0.001***	0.02 (6)	0.02 (5)	0.29	0.03 (8)	0.06 (15)	0.006**
Optometry	0.11	0.11 (19)	0.12 (21)	0.03*	0.09 (15)	0.13 (21)	<0.001***	0.06 (10)	0.14 (24)	<0.001***
Orthopedic	0.11	0.1 (19)	0.12 (23)	<0.001***	0.04 (7)	0.11 (21)	<0.001***	0.08 (15)	0.12 (24)	<0.001***
Dental	0.04	0.02 (7)	0.05 (15)	<0.001***	0.01 (3)	0.04 (11)	0.02	0.03 (8)	0.07 (20)	<0.001***

^†VHA Fiscal Year (FY) October 1 to September 30.

^‡RCC represents rural Veterans using Community Care.

^§RVA represents rural Veterans using Veterans Health Affairs.

^∥UCC represents urban Veterans using Community Care.

^¶UVA represents urban Veterans using Veterans Health Affairs.

^#Rural versus urban.

^††CC versus VA.

^‡‡P-value reported for (FY15 probability−FY18 probability).

^*P≤0.05.

^**P<0.01.

^***P<0.001.