The study analyzed more than 10 million specialty care referrals from 2018 to 2022.

It included nearly 4.4 million veterans and examined both VHA and community-based specialty care.

Black veterans had the longest average wait times: 40.0 days within VHA and 52.9 days in community care.

Over half of all referrals exceeded the VHA’s 28-day access standard.

Facility-level differences accounted for most racial disparities in access to care.

Specialty type, comorbidity burden, and patient age contributed less to the disparities.

Researchers recommended improving healthcare quality and supply in under-resourced areas to promote equity.