Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

1067 — Gender Differences in VA Healthcare Satisfaction and Health Risk among OIF/OEF Veterans

Straits-Troster KA (VISN 6 MIRECC & Duke University) , Calhoun PS (VISN 6 MIRECC & Duke University), Roberts ST (VISN 6 MIRECC), Jones ER (VISN 6 MIRECC), Kudler H (VISN 6 MIRECC & Duke University), Hostler D (Duke University), Elter J (VA Office of Quality and Performance)

Objectives:
VA healthcare has been made available to over 500,000 combat veterans who have served in Iraq (OIF) or Afghanistan (OEF). This study examined satisfaction with VA healthcare and prevalence of potential health risks among a national sample of OIF/OEF men and women veterans.

Methods:
Secondary data analysis of the national VA outpatient Survey of Healthcare Experiences of Patients (SHEP). Surveys were mailed to a random sample of veterans seen in VA clinics during the previous 60 days in FY2005. Sample stratification was designed to provide stable clinic-level estimates. Satisfaction was assessed using dimensions from the Veterans Healthcare Service Standards (VHSS) measure. Body mass index (BMI) was estimated based upon height and weight report. Association of satisfaction, health risks, and gender were assessed using weighted regression analyses.

Results:
OIF/OEF survey participants (n=1104) ranged in age from 20 to 62 years (M=36.6; SD 10.7); 31% reported non-White race/ethnicity and 65% served in Reserve/National Guard. Comparisons between women (n=180; 16%) and men (n=924; 83.7%) revealed that women were younger (t=6.5; p<.001) and more likely to be unmarried (70.1% vs. 40.1%; p<.001). After controlling for age, education, race, marital status, and health status (fair/poor vs. good/ very good/excellent), women reported better continuity of care compared to men [(1,1029) F= 3.5; p=.003]. No gender differences were found for care access, courtesy, emotional support, or informational support. Women were less likely to be overweight/obese (BMI>25; OR=0.41; 95%CI 0.29-0.59) in analyses controlled for age, race, education, and marital status. No gender differences were found for smoking or for provider advice to quit smoking. Among all smokers (25.4%), 70% reported having been advised to quit. In adjusted analyses controlling for all demographic variables, smoking was the only health risk behavior associated with increased risk of fair/poor health status (OR 1.7; 95%CI 1.1-2.6).

Implications:
OIF/OEF veteran men and women report comparable satisfaction with VA healthcare across most domains. Health risk behaviors prevalent among OIF/OEF veterans include smoking and overweight/obesity.

Impacts:
Healthcare for this new generation of combat veterans must include best practices for efficient screening and effective intervention to reduce health risks, including smoking cessation and weight management.