In the late 1800s, several district nurse associations began to form in the
northeastern United States based on the British
district nurse model. Among the first district nurse associations in the United States were the Buffalo District Nursing Association in 1885, The Boston Instructive District Visiting Nurse Association in 1886, Visiting Nurse Association of Philadelphia in 1886, and the Chicago Visiting Nurse Association in 1889. The current VNA model finds its origins in the
Visiting Nurse Service of New York founded by nursing pioneer
Lillian D. Wald in 1893 to teach home classes on nursing and healthcare to poor immigrants in New York's
Lower East Side. Today there are over 12,000 home health care agencies listed on the Medicare database. In 2004, the
United States Congress recommended the establishment of a Visiting Nurse Association Week reporting that there are over 500 individual VNAs in the United States employing over 90,000 clinicians which provides healthcare to 4,000,000 people annually. In the same report they claimed that VNAs are one of the largest providers of immunizations in the Medicare program with more than 2,500,000 influenza immunizations given manually. ==References==