Racial Disparities in VA Appointment Wait Times Worsened Amid COVID-19

Prior to the COVID-19 pandemic, Black and Hispanic veterans seeking medical care through the Department of Veterans Affairs (VA) were more likely to face longer VA appointment wait times. Recent data has shown that these disparities only worsened as the COVID-19 pandemic played out.

The study, containing data for more than one million veterans, examined the implications of COVID-19 disruptions and policy changes on veterans following the pandemic.

Extensive research has shown that the US Veterans Health Administration (VHA)—a branch of the VA that facilitates healthcare delivery for nearly nine million veterans—is not immune to care access challenges, which are notably worse for minority patients.

To improve access to care for veterans, Congress rolled out several policies, including the VA MISSION (Maintaining Systems and Strengthening Integrated Outside Networks) Act in 2018. 

These programs, created in response to the VA wait time scandal in 2014, provided veterans with community care options to access primary, emergency, mental health, and other specialty care at non-VA health facilities.

In this study, researchers used patient consultation data to evaluate changes in wait times for outpatient orthopedic and cardiology services among Black and Hispanic veterans compared with White veterans between 2019 and 2021.

Additionally, the researchers assessed whether there were changes in overall and facility-level wait time disparities during the COVID-19 period compared with the pre–COVID-19 period.

According to the findings, overall wait times increased substantially during the COVID-19 pandemic.

During COVID-19, Black veterans waited nearly 4.74 more days for cardiology services, and Hispanic veterans waited 5.09 more days compared to their White counterparts, who waited 4.48 more days. The researchers also noticed that the wait disparities within cardiology services increased by 0.27 days for Black patients and 0.60 days for Hispanic patients.

For orthopedic services, patient appointment wait times increased by nearly 3.75 days for White veterans, 4.10 days for Black veterans, and 4.40 days for Hispanic veterans during COVID-19. The wait time disparities grew by 0.36 days for Black veterans and 0.69 days for Hispanic veterans.

“This finding was consistent with our expectation that despite MISSION, wait time disparities would increase, given the disproportionate impact of COVID-19 on Black and Hispanic communities,” the researchers wrote.

“Overall, these increases resulted in notable wait time disparities for Black and Hispanic veterans compared with White veterans for orthopedic services but only modest disparities for cardiology,” the researchers continued. “The relatively modest increase in disparities for cardiology could be due to the rapid expansion in the VHA’s use of telehealth early in the pandemic.”

These findings mirror other studies conducted since the start of the pandemic, confirming that Black and Hispanic patients experienced disproportionate care access barriers compared to White people.

Cancer care access was delayed for many Americans during the pandemic. Still, minority patients experienced the most significant delays in cancer care access.

Past studies show that Black and Latinx respondents were three times more likely to experience modifications in cancer care, including delayed clinic visits, laboratory tests, and imaging, and a change in location of care, compared to White participants.