Health Services Research & Development

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2006 HSR&D National Meeting Abstract


3086 — Gender Differences in Medical Conditions, Utilization, and Costs of Care for Veterans Using VA Care

Author List:
Phibbs CS (Health Economics Resource Center)
Frayne SM (Center for Health Care Evaluation)
Yu W (Health Economics Resource Center)
Ananth L (Health Economics Resource Center)
Iqbal S (Palo Alto VA Health Care System)
Thrailkill A (Palo Alto VA Health Care System)
Yano E (Center for the Study of Healthcare Provider Behavior)

Objectives:
This study examined whether disease burden, utilization, and costs of VA care differ between female and male veterans.

Methods:
All users of VA care in FY 2002 were identified from VA administrative data (PTF and NPCD). Analyses were restricted to veterans (178,463 women and 3,940,148 men). A modified version of AHRQ's Clinical Classifications Software was used to describe the clinical conditions of patients. Descriptive statistics were used to compare presence and absence of medical and mental health conditions, utilization, and costs, by gender. Logistic regressions were used to estimate the age-adjusted odds ratios (OR) of the clinical conditions by gender. Linear regression was used to compare differences in utilization and costs by gender, controlling for age and clinical conditions.

Results:
Half of the women who received VA care were not veterans, compared to only 3% of males. Women veterans were younger than men, less likely to be married, and more likely to have a service-connected disability. Chronic conditions were common in both men and women veterans. Several conditions were more common in women than in men, for example, osteoporosis (age-adjusted OR 13.6). Mean total annual outpatient encounters per patient were 16.9 for women veterans and 15.1 for veteran men. Mean total annual inpatient days per patient was 1.9 days for women veterans and 2.5 days for male veterans. Mean total annual cost per patient was $3,941 for veteran women and $4,446 for veteran men. Adjusting for age and medical conditions, women veterans had 1% more outpatient encounters, 11% fewer inpatient days, and 3% less total cost.

Implications:
There are substantial gender differences in the conditions, utilization, and costs for veterans receiving VA care. After accounting for differences in age and clinical conditions, however, costs and utilization were similar across genders.

Impacts:
VA's efforts to build capacity for the growing women veteran population must account for the spectrum of medical conditions in this special population, which cross the life span and include both gender-specific and gender-neutral diseases. VA projections should anticipate that per capita utilization and costs for women veterans will be similar to those of men.