Kristin M Mattocks1, Susan Frayne2, Ciaran S Phibbs3, Elizabeth M Yano4, Laurie Zephyrin5, Holly Shryock6, Sally Haskell7, Jodie Katon8, J Cherry Sullivan9, Linda Weinreb10, Christine Ulbricht11, Lori A Bastian12. 1. Research and Development, VA Central Western Massachusetts, Leeds, Massachusetts; Department of Quantitative Health Science, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: Kristin.Mattocks@va.gov. 2. Center for Health Care Evaluation, VA HSR&D Center of Excellence, VA Palo Alto Health Care System, Palo Alto, California; Division of General Medical Disciplines, Stanford University, Palo Alto, California; Center for Primary Care and Outcomes Research, Stanford University, Palo Alto, California. 3. Health Economics Resource Center, VA Palo Alto Health Care System Center for Health Care Evaluation, VA Palo Alto Health Care System, Palo Alto, California; Department of Pediatrics, Stanford University School of Medicine, Center for Primary Care and Outcomes Research, Stanford University School of Medicine. 4. VA Greater Los Angeles HSR&D Center of Excellence for the Study of Healthcare Provider Behavior, Sepulveda, California; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California. 5. Director, Reproductive Health, Women's Health Services, Office of Patient Care Services, Department of Veterans Affairs, New York, New York. 6. VHA Chief Business Office, Purchased Care - Program Oversight and Informatics, Denver, Colorado. 7. VA Connecticut Healthcare System, Yale University School of Medicine, West Haven, Connecticut. 8. VA Puget Sound Health Care System, Seattle, Washington; Department of Health Services, University of Washington, School of Public Health, Seattle, Washington. 9. VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts. 10. Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts. 11. University of Massachusetts Medical School, Worcester, Massachusetts. 12. VA Connecticut, Newington, Connecticut; Division of General Internal Medicine, University of Connecticut, Farmington, Connecticut.
Abstract
BACKGROUND: An increasing number of young women veterans are returning from war and military service and are seeking reproductive health care from the Veterans Health Administration (VHA). Many of these women seek maternity benefits from the VHA, and yet little is known regarding the number of women veterans utilizing VHA maternity benefits nor the characteristics of pregnant veterans using these benefits. In May 2010, VHA maternity benefits were expanded to include 7 days of infant care, which may serve to entice more women to use VHA maternity benefits. Understanding the changing trends in women veterans seeking maternity benefits will help the VHA to improve the quality of reproductive care over time. OBJECTIVE: The goal of this study was to examine the trends in delivery claims among women veterans receiving VHA maternity benefits over a 5-year period and the characteristics of pregnant veterans utilizing VHA benefits. DESIGN: We undertook a retrospective, national cohort study of pregnant veterans enrolled in VHA care with inpatient deliveries between fiscal years (FY) 2008 and 2012. PARTICIPANTS: We included pregnant veterans using VHA maternity benefits for delivery. MAIN MEASURES: Measures included annualized numbers and rates of inpatient deliveries and delivery-related costs, as well as cesarean section rates as a quality indicator. KEY RESULTS: During the 5-year study period, there was a significant increase in the number of deliveries to women veterans using VHA maternity benefits. The overall delivery rate increased by 44% over the study period from 12.4 to 17.8 deliveries per 1,000 women veterans. A majority of women using VHA maternity benefits were age 30 or older and had a service-connected disability. From FY 2008 to 2012, the VHA paid more than $46 million in delivery claims to community providers for deliveries to women veterans ($4,993/veteran). CONCLUSIONS: Over a 5-year period, the volume of women veterans using VHA maternity benefits increased by 44%. Given this sizeable increase, the VHA must increase its capacity to care for pregnant veterans and ensure care coordination systems are in place to address the needs of pregnant veterans with service-connected disabilities. Published by Elsevier Inc.
BACKGROUND: An increasing number of young women veterans are returning from war and military service and are seeking reproductive health care from the Veterans Health Administration (VHA). Many of these women seek maternity benefits from the VHA, and yet little is known regarding the number of women veterans utilizing VHA maternity benefits nor the characteristics of pregnant veterans using these benefits. In May 2010, VHA maternity benefits were expanded to include 7 days of infant care, which may serve to entice more women to use VHA maternity benefits. Understanding the changing trends in women veterans seeking maternity benefits will help the VHA to improve the quality of reproductive care over time. OBJECTIVE: The goal of this study was to examine the trends in delivery claims among women veterans receiving VHA maternity benefits over a 5-year period and the characteristics of pregnant veterans utilizing VHA benefits. DESIGN: We undertook a retrospective, national cohort study of pregnant veterans enrolled in VHA care with inpatient deliveries between fiscal years (FY) 2008 and 2012. PARTICIPANTS: We included pregnant veterans using VHA maternity benefits for delivery. MAIN MEASURES: Measures included annualized numbers and rates of inpatient deliveries and delivery-related costs, as well as cesarean section rates as a quality indicator. KEY RESULTS: During the 5-year study period, there was a significant increase in the number of deliveries to women veterans using VHA maternity benefits. The overall delivery rate increased by 44% over the study period from 12.4 to 17.8 deliveries per 1,000 women veterans. A majority of women using VHA maternity benefits were age 30 or older and had a service-connected disability. From FY 2008 to 2012, the VHA paid more than $46 million in delivery claims to community providers for deliveries to women veterans ($4,993/veteran). CONCLUSIONS: Over a 5-year period, the volume of women veterans using VHA maternity benefits increased by 44%. Given this sizeable increase, the VHA must increase its capacity to care for pregnant veterans and ensure care coordination systems are in place to address the needs of pregnant veterans with service-connected disabilities. Published by Elsevier Inc.
Authors: Jonathan G Shaw; Vilija R Joyce; Susan K Schmitt; Susan M Frayne; Kate A Shaw; Beate Danielsen; Rachel Kimerling; Steven M Asch; Ciaran S Phibbs Journal: Health Serv Res Date: 2018-09-10 Impact factor: 3.402
Authors: Sarah M Wilson; Alyssa M Medenblik; Julia M Neal; Jennifer L Strauss; J Murray McNiel; Warren E Christian; Jean C Beckham; Patrick S Calhoun Journal: Qual Health Res Date: 2019-07-16
Authors: Jodie G Katon; Laurie Zephyrin; Anne Meoli; Avanthi Hulugalle; Jeane Bosch; Lisa Callegari; Ileana V Galvan; Kristen E Gray; Kristin O Haeger; Claire Hoffmire; Silvina Levis; Erica W Ma; Jennifer E Mccabe; Yael I Nillni; Suzanne L Pineles; Shivani M Reddy; David A Savitz; Jonathan G Shaw; Elizabeth W Patton Journal: Semin Reprod Med Date: 2019-04-19 Impact factor: 1.303
Authors: Elisheva R Danan; Erin E Krebs; Kristine Ensrud; Eva Koeller; Roderick MacDonald; Tina Velasquez; Nancy Greer; Timothy J Wilt Journal: J Gen Intern Med Date: 2017-09-14 Impact factor: 5.128