Utilizing Geospatial Mapping to Identify High-Need Areas for Pelvic Health Rehabilitation and Inform Strategic Health System Planning

INTRODUCTION: Pelvic floor dysfunction detrimentally impacts function. Pelvic Health Rehabilitation (PHR) is a first-line, non-invasive treatment. However, access to PHR services is deficient due to lack of trained rehabilitation providers, limited public awareness of its value, and knowledge gaps among potential referral sources. The purpose of this project was to (1) use geospatial mapping to identify areas of need for PHR services in the Veterans Health Administration (VHA) and (2) apply the results to create a feedback loop to guide VHA strategic planning. MATERIALS AND METHODS: Veteran data were extracted from clinical and administrative data sources, where pelvic health-related diagnostic codes were queried to reflect Veterans who could potentially benefit from PHR services. Data were summarized by the 96 VHA market geographic areas based on the Veteran's home residence. The number of VHA PHR providers was extracted from a national directory based on provider self-report. Data were imported into a Geographic Information System (GIS) software application to visualize maps. RESULTS: A total of 2,746,003 Veterans had a diagnosis that would potentially benefit from PHR services. The highest need areas also were those with the least access to in-house VHA PHR services, with the VHA employing 117 Pelvic Health Physical Therapists nationally. CONCLUSIONS: Geospatial mapping and analyses allows for visualization of gaps in PHR access across the VHA system. This information is being utilized by clinical and operational partners to develop a multi-modal approach to building PHR workforce capacity with the goal of increasing timely Veteran access to PHR services.