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2015 HSR&D/QUERI National Conference Abstract

1083 — Gender Differences in Satisfaction with VA Health Care

Zickmund SL, CHERP VA Pittsburgh Healthcare System; Gao S, CHERP VA Pittsburgh Healthcare System; Borrero S, CHERP VA Pittsburgh Healthcare System; Stone RA, CHERP VA Pittsburgh Healthcare System; Hausmann LH, CHERP VA Pittsburgh Healthcare System; Burkitt KH, CHERP VA Pittsburgh Healthcare System; Switzer GE, CHERP VA Pittsburgh Healthcare System; Obrosky DS, CHERP VA Pittsburgh Healthcare System; Rodriguez KL, CHERP VA Pittsburgh Healthcare System; Fine MJ, CHERP VA Pittsburgh Healthcare System

VA is committed to equal treatment for all Veterans; however, concerns exist that women are not as satisfied as their male counterparts with VA health care. We sought to examine gender differences in satisfaction with VA care in a racially-diverse patient sample.

Our study of gender, race, and ethnic differences in satisfaction with VA care drew Veterans from 25 VA Medical Centers (VAMCs). From 6/13-1/15, we invited a sample of Veterans who had > 1 outpatient visits in the prior 12 months to complete a telephone interview on satisfaction with VA care overall and within 15 distinct domains (e.g., access, respect). We used a 5-category Likert scale (very satisfied to very dissatisfied) to classify satisfaction. We assessed proportions of patients who were "very satisfied," "somewhat satisfied," or were in the 3 remaining categories (collapsed due to small numbers). Then we used mixed-effects multinomial regression to model gender differences in satisfaction overall and by domain. Models included fixed effects for gender, age, race/ethnicity, gender-by-race/ethnicity interaction, and random effects for VAMCs to account for clustering of Veterans within facilities.

Of 1,928 eligible Veterans, 1,203 (62%) completed the Likert questions, including 589 (49%) men and 614 (51%) women. Overall, 53% males and 43% females were "very satisfied" with overall VA care (unadjusted chi-square test with p < 0.01). We found at least 10 percent point differences by gender in being "very satisfied" in the following domains: outpatient care (p < 0.01), access (p < 0.01), coordination of care (p < 0.01), respect (p < 0.01), and inpatient care (p = 0.01). In our multinomial models, white women were less satisfied than white men in the domains of outpatient care, respect, and main and clinic facility; black women were less satisfied than black men in access, pharmacy, and respect; and Hispanic women were less satisfied than Hispanic men in mental health and inpatient care.

Women Veterans are less satisfied than men with VA within select domains of care. Across domains, gender differences in satisfaction vary by race/ethnicity.

Understanding gender differences in satisfaction and how these differences vary by race/ethnicity will enable VA to improve the health care experiences for the growing number of racially diverse female Veterans.