Wartime military service and utilization of VA health care services.

This study sought to examine predisposing, enabling, and illness characteristics associated with use of Department of Veterans Affairs (VA) health care services. In view of VA's unique mission to care for war veterans, special attention was given to features of wartime military service as predisposing factors for VA health care use. Data from a 1987 national survey of veterans were used to compare VA users and non-users. Logistic regression analysis was used to identify specific variables independently associated with VA health service use. Among current VA health service users, 55% served in combat and 71% in a war zone. Multivariate analysis showed that high illness level, service-connected disability status, and lack of health insurance are the strongest predictors of VA service use. Significant associations were also found between military service during a wartime era, in a war zone, and in combat, and VA health service utilization. Although no differences were noted in VA health service use between veterans of different wartime eras, it was notable that among Korean War-era veterans alone, war zone and combat exposure were not associated with increased VA health service use, perhaps reflecting the more limited public attention that has been paid to veterans of that war. Veterans with war-related military experience show a distinct affinity for VA services.