Rural and Urban Home Modification Program Users: A Comparative Study

Luz M. Semeah, Tatiana Orozco, Xinping Wang, Zaccheus J. Ahonle, Diane Cowper-Ripley, Shanti P. Ganesh, Lauren K. Wilson, Eric R. Litt, Justin K. Ahern, Leslie M. Santos Roman, Deepthi Satheesa Varma, Mi Jung Lee, Jonathan R. Novak, Huanguang Jia

Research output: Contribution to journalArticlepeer-review


Objective: To understand the sociodemographic, geographical, and clinical characteristics of rural veterans utilizing home modification (HM) healthcare services under the Home Improvement Structural Alterations (HISA) program, to compare these characteristics between rural and urban veteran users, to estimate the costs of HMs performed, and to present distance that users traveled to HISA-prescribing medical facilities within the Veterans Health Administration (VHA). Background: Accessible housing is in short supply. HMs allow veterans with disabilities (VWDs) to remain living at home rather than enter institutional-type settings. HISA is associated with decreased inpatient hospitalization rates and increased use of preventative healthcare via outpatient clinic visits. Home accessibility provides psychological benefits improving social interactions and interaction with the physical environment. Methods: This retrospective database study analyzes data from the National Prosthetics Patient Database and other medical datasets within the VHA. Results: Results provide a profile of and comparison between rural and urban veteran users. HISA users are substantially older compared to younger VWDs. The frequency of bathroom, railing, and wooden ramp HMs differed significantly between rural and urban users (p values <.001). Rural users traveled more miles than urban users to reach a prescribing facility. Conclusions: Older adults and individuals with disabilities have unmet housing needs since accessible housing is in short supply. This HM healthcare service is helping to meet the housing accessibility needs of older veterans, VWDs, older adults, and people with disabilities, in general.

Original languageEnglish (US)
StateAccepted/In press - 2023


  • cost
  • geospatial
  • healthcare services
  • home modification
  • rural

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Critical Care and Intensive Care Medicine


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