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Publication Briefs

Study Examines Barriers to Healthcare Access for Women Veterans

In 2010, VA embarked on a system-wide transformation that aims to provide all Veterans with timely access to quality healthcare in a Veteran-centered manner. Expanding healthcare access for women Veterans is one of the top three strategic initiatives in this transformation. However, it is unknown how general and Veteran-specific determinants of VA healthcare use impact overall receipt of needed healthcare. This study examined the association of general and Veteran-specific barriers on access to healthcare among women Veterans. Using data from the National Survey of Women Veterans (national telephone survey conducted 2008-09), investigators identified 3,608 women Veterans who provided information regarding delayed healthcare or unmet healthcare need in the prior 12 months. Independent variables that were examined included: socio-demographics, insurance status, overall health status, disability, and diagnosed mental health conditions.


  • Overall, almost 1 in 5 women Veterans (19%) delayed healthcare or went without needed care in the prior 12 months, including 14% of insured and 55% of uninsured women Veterans. VA healthcare users comprised 21% of those with and 13% of those without delayed healthcare or unmet needs.
  • Younger age groups were associated with a higher prevalence of delayed care or unmet need: 36% of 18-34 yr-olds; 29% of 35-49 yr-olds; 16% of 50-64 yr-olds; and 7% of 65+ yr-olds.
  • Among women Veterans delaying or going without care, barriers that varied by age group were: unaffordable healthcare (63% of 18-34 vs. 12% of 65+ age groups); inability to take time off work (39% of those younger than age 50); and transportation difficulties (36% of those age 65+).
  • A higher percentage of women with delayed care or unmet need, compared to those without, were racial/ethnic minorities, lacked a regular source or provider of healthcare, were uninsured, had low income, fair or poor health status, were disabled, and had mental health diagnoses.
  • With respect to Veteran-related factors, women Veterans with delayed care or unmet need were more likely than those without to be OEF/OIF Veterans, in a high-priority group for VA enrollment, and to have experienced military sexual assault.


  • Investigators did not assess the seriousness of the condition for which healthcare was delayed or not obtained, the length or number of delays over 12 months, or the health consequences.
  • In this sample, there may have been under-coverage of Veterans without a telephone – a group likely to have significant access to healthcare barriers.

This study was partly funded by HSR&D (SDR 08-270). Dr. Yano was also supported by an HSR&D Research Career Scientist Award, and Dr. Bean-Mayberry was supported by an HSR&D Career Development Transition Award. All authors are part of HSR&D’s Center for the Study of Healthcare Provider Behavior.

PubMed Logo Washington DL, Bean-Mayberry B, Riopelle D, and Yano EM. Access to Care for Women Veterans: Delayed Healthcare and Unmet Need. Journal of General Internal Medicine 2011 Nov;26 Suppl 2:655-61.

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What are HSR Publication Briefs?

HSR requires notification by HSR-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR published articles. Visit the HSR citations database for a complete listing of HSR articles and presentations.

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