Evaluation of the VA mobile clinics demonstration project

In 1988 the Veterans' Benefits and Services Act attempted to solve the prob lem of the lack of adequate VA healthcare facilities in rural areas by esta blishing a demonstration program using mobile clinics. Six clinics operated in areas that were at least 100 miles from a VA healthcare facility during the time period between October 1, 1992 and May 28, 1994. This article eva luated the effect of the mobile clinics' structural limitations on clinical care, the increased number of sites on VA usage, and cost. Limited space for storage of medical records and the unavailability of labo ratory, electrocardiographic, or radiographic facilities significantly affe cted clinical practice. However, even with these space limitations, veteran s' use of healthcare in the areas served by the mobile clinics increased si gnificantly in comparison to reference areas. The direct costs per visit av eraged more than three times what the VA would have reimbursed the private sector.