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Health Services Research & Development

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2005 HSR&D National Meeting Abstract


3056 — To Use or Not to Use – Reasons Women Veterans Choose VA Versus Non-VA Health Care Services

Author List:
Washington DL (VA Greater Los Angeles Healthcare System)
Simon B (VA Greater Los Angeles Healthcare System)
Sasso B (VA Greater Los Angeles Healthcare System)
Canning M (VA Greater Los Angeles Healthcare System)
Sun S (VA Greater Los Angeles Healthcare System)
Yano EM (VA Greater Los Angeles Healthcare System)

Objectives:
The number of women in the military is growing rapidly, resulting in an increase in women veterans eligible for VA care. Prior research demonstrates that women veterans under-utilize VA ambulatory care services compared with male veterans. Our objective was to assess the reasons that women veterans use or do not use VA healthcare.

Methods:
We conducted a telephone survey of a stratified random sample of women veterans residing in the southern California and southern Nevada area (VISN22). Stratification was by current VA use and age group. All analyses applied weights to account for the disproportional allocation of the population by strata.

Results:
1,070 women veteran VA-users and 1,086 non-users were surveyed. VA-users cited affordability (67.8%); availability of a women’s health clinic (58.7%); quality of care (54.8%); and convenience (48.0%) as reasons for VA use. Among VA non-users, commonly cited reasons for not using VA healthcare were: already paying for insurance that covers healthcare outside the VA (68.7%); non-VA care being more convenient (64.8%); lack of knowledge of VA eligibility and benefits (46.8%); and perception that non-VA quality of care is better (32.1%). VA-users and non-users differed in rates of insurance coverage (54.0% versus 91.9%, respectively); ratings of VA quality (73.1% versus 30.4% rating VA quality 8 or higher on 10-point scale); and knowledge of VA healthcare benefits (5.2% versus 52.7% having none or almost none of the information they need) (all p<0.0001). VA-users were as likely as non-users to have an identified usual provider (PCP) for care (77.4% versus 72.5%), but less likely to have primary care continuity (67.2% versus 82.2% very likely to get appointment with their PCP when scheduling a healthcare visit, p<0.0001) or after-hours access (12.4% versus 30.1% able to schedule an evening or weekend appointment for routine care, p<0.0001).

Implications:
For many women veterans, lack of knowledge of VA eligibility and benefits, perceptions of VA quality, and inconvenience of VA care, are deterrents to VA use.

Impacts:
An education campaign is needed to fill the information gap regarding women veterans’ VA eligibility and advances in VA quality of care, while VA managers consider solutions to access and continuity barriers.


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