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2011 HSR&D National Meeting Abstract

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2011 National Meeting

3003 — The Decade in Review: Trends in Outpatient Utilization among Women Veterans

Berg E (COE-Palo Alto), Laungani K (COE-Palo Alto), Friedman SA (COE-Palo Alto), Phibbs CS (COE-Palo Alto), Herrera L (VACO), Hayes PM (VACO), Frayne SM (COE-Palo Alto)

Objectives:
Increasing numbers of women serve in the United States military, so an increase in women veterans’ health care through the Veterans Health Administration (VHA) is anticipated. We examined annual use of any outpatient care, primary care (PC), and mental health (MH) care over the past decade.

Methods:
For all women veterans using outpatient care based on the National Patient Care Database, we examined utilization annually for FY97 to FY09. Clinic stop codes were used to identify PC and MH visits. For each year, we examined number of users of any outpatient care, PC and MH care, proportion using PC and MH care, and mean number of visits to PC and MH clinics.

Results:
The number of women veterans receiving outpatient VHA care more than doubled between FY97 (118,218 women) and FY09 (275,661 women), with a progressive increase in each year. The number of women receiving at least one PC visit increased 184% (FY97: 88,071; FY09: 250,334) and the number receiving at least one MH care visit increased 170% (FY97: 40,800; FY09: 110,282). From FY97 to FY09, the percentage of women outpatient users receiving PC rose from 74% to 91%, and the percentage receiving MH care rose from 35% to 40%. PC visits increased by 593,798 (171%) (FY97: 348,030; FY09: 941,828) and MH visits increased by 595,925 (144%) (FY97: 414,866; FY09: 1,010,791). In FY09, women PC users had a mean of 3.8 PC visits, and women MH users had a mean of 9.2 MH visits.

Implications:
The number of women veterans receiving any outpatient care, PC, and MH care in VHA has steadily increased from FY97 to FY09. Nearly all now receive PC, suggesting that efforts to assure that women are connected to a PC home are increasingly successful. A large proportion receive MH care as well; increase in MH use could reflect recent innovations such as systematic screening for mental illness or addition of embedded MH providers in primary care settings.

Impacts:
Assuming continuation of these growth trends, VHA will need to assure that PC and MH services for women are augmented sufficiently to meet escalating demand.


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