Kate L Sheahan1, Karen M Goldstein2,3, Claire T Than4, Bevanne Bean-Mayberry4,5, Catherine C Chanfreau4,6, Megan R Gerber7,8, Danielle E Rose4, Julian Brunner4, Ismelda A Canelo4, Jill E Darling Mshs9, Sally Haskell10,11,12, Alison B Hamilton4,13, Elizabeth M Yano4,5,14. 1. JSI, Inc., 2733 Crystal Dr 4th floor, Arlington, VA, 22202, USA. kate_sheahan@jsi.com. 2. JSI, Inc., 2733 Crystal Dr 4th floor, Arlington, VA, 22202, USA. 3. Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA. 4. VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. 5. Department of Medicine, University of California, Los Angeles (UCLA) Geffen School of Medicine, Los Angeles, CA, USA. 6. Veterans Affairs Informatics and Computing Infrastructure (VINCI), Salt Lake City, UT, USA. 7. Albany Stratton VA Medical Center, Albany, NY, USA. 8. Division of General Internal Medicine, Albany Medical College, Albany, NY, USA. 9. Center for Economic and Social Research (CESR), University of Southern California, Los Angeles, CA, USA. 10. Pain Research, Informatics, Multi-morbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA. 11. Division of General Internal Medicine, Department of Medicine, Yale University School of Medicine, West Haven, CT, USA. 12. Office of Women's Health, Veterans Health Administration, Washington, DC, USA. 13. Department of Psychiatry and Biobehavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, USA. 14. Department of Health Policy & Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
Abstract
BACKGROUND: The Veterans Health Administration (VA) is the largest integrated health system in the US and provides access to comprehensive primary care. Women Veterans are the fastest growing segment of new VA users, yet little is known about the characteristics of those who routinely access VA primary care in general or by age group. OBJECTIVE: Describe healthcare needs, utilization, and preferences of women Veterans who routinely use VA primary care. PARTICIPANTS: 1,391 women Veterans with 3+ primary care visits within the previous year in 12 VA medical centers (including General Primary Care Clinics, General Primary Care Clinics with designated space for women, and Comprehensive Women's Health Centers) in nine states. METHODS: Cross-sectional survey (45% response rate) of sociodemographic characteristics, health status (including chronic disease, mental health, pain, and trauma exposure), utilization, care preferences, and satisfaction. Select utilization data were extracted from administrative data. Analyses were weighted to the population of routine users and adjusted for non-response in total and by age group. KEY RESULTS: While 43% had health coverage only through VA, 62% received all primary care in VA. In the prior year, 56% used VA mental healthcare and 78% used VA specialty care. Common physical health issues included hypertension (42%), elevated cholesterol (39%), pain (35%), and diabetes (16%). Many screened positive for PTSD (41%), anxiety (32%), and depression (27%). Chronic physical and mental health burdens varied by age. Two-thirds (62%) had experienced military sexual trauma. Respondents reported satisfaction with VA women's healthcare and preference for female providers. CONCLUSIONS: Women Veterans who routinely utilize VA primary care have significant multimorbid physical and mental health conditions and trauma histories. Meeting women Veterans' needs across the lifespan will require continued investment in woman-centered primary care, including integrated mental healthcare and emphasis on trauma-informed, age-specific care, guided by women's provider preferences.
BACKGROUND: The Veterans Health Administration (VA) is the largest integrated health system in the US and provides access to comprehensive primary care. Women Veterans are the fastest growing segment of new VA users, yet little is known about the characteristics of those who routinely access VA primary care in general or by age group. OBJECTIVE: Describe healthcare needs, utilization, and preferences of women Veterans who routinely use VA primary care. PARTICIPANTS: 1,391 women Veterans with 3+ primary care visits within the previous year in 12 VA medical centers (including General Primary Care Clinics, General Primary Care Clinics with designated space for women, and Comprehensive Women's Health Centers) in nine states. METHODS: Cross-sectional survey (45% response rate) of sociodemographic characteristics, health status (including chronic disease, mental health, pain, and trauma exposure), utilization, care preferences, and satisfaction. Select utilization data were extracted from administrative data. Analyses were weighted to the population of routine users and adjusted for non-response in total and by age group. KEY RESULTS: While 43% had health coverage only through VA, 62% received all primary care in VA. In the prior year, 56% used VA mental healthcare and 78% used VA specialty care. Common physical health issues included hypertension (42%), elevated cholesterol (39%), pain (35%), and diabetes (16%). Many screened positive for PTSD (41%), anxiety (32%), and depression (27%). Chronic physical and mental health burdens varied by age. Two-thirds (62%) had experienced military sexual trauma. Respondents reported satisfaction with VA women's healthcare and preference for female providers. CONCLUSIONS: Women Veterans who routinely utilize VA primary care have significant multimorbid physical and mental health conditions and trauma histories. Meeting women Veterans' needs across the lifespan will require continued investment in woman-centered primary care, including integrated mental healthcare and emphasis on trauma-informed, age-specific care, guided by women's provider preferences.
Authors: Stephen M Petterson; Winston R Liaw; Robert L Phillips; David L Rabin; David S Meyers; Andrew W Bazemore Journal: Ann Fam Med Date: 2012 Nov-Dec Impact factor: 5.166
Authors: Aimee R Kroll-Desrosiers; Sybil L Crawford; Tiffany A Moore Simas; Melissa A Clark; Lori A Bastian; Kristin M Mattocks Journal: Womens Health Issues Date: 2019-05-16
Authors: Keren Lehavot; Katherine D Hoerster; Karin M Nelson; Matthew Jakupcak; Tracy L Simpson Journal: Am J Prev Med Date: 2012-05 Impact factor: 5.043
Authors: Jennifer C Naylor; H Ryan Wagner; Mira Brancu; Megan Shepherd-Banigan; Eric Elbogen; Michelle Kelley; Teresa Fecteau; Karen Goldstein; Nathan A Kimbrel; Christine E Marx; Jennifer L Strauss Journal: Pain Med Date: 2017-09-01 Impact factor: 3.750