Use of VA health care services by women veterans: findings from a national sample.

The Department of Veterans Affairs (VA) has a Congressional mandate but few empirical data on which to design and improve national health care services for women. We examined characteristics associated with women's current, former and non-use of the VA health care system. The study included 1,500 female veterans sampled from the Department of Veterans Affairs National Registry of Women Veterans. Women completed a 45-minute telephone survey assessing multiple domains of functional status and health service use. Using multivariate logistic regression, use of VA health care was associated with older age, more education, not being married, lower rates of insurance coverage, and poorer physical and psychological health. Women who were former users of VA health care were more likely to be ethnic minorities, have children, served less time in the military, had higher rates of insurance coverage and better physical and psychological health than current users. Prominent military experiences (e.g., service in a war-zone, exposure to trauma) were associated with former use and never using the VA health care system. Women who use VA health care are at greater economic, social, and health risk than nonusers, factors that have personal implications for the veteran as well as cost and service implications for VA. Additional research is needed to better understand the role of military experiences in women veterans' choice of health care.