Changes in Health Conditions and VA Healthcare Costs among Women Veterans between 2000 and 2008
BACKGROUND:
As women gain a greater presence in the armed forces, attention is being directed towards understanding their need for and utilization of healthcare in the VA healthcare system. To plan for the growing influx of women Veterans, VA needs information about the costs of common conditions. This study examined rates of specific health conditions among female Veterans — and how the share of healthcare costs attributable to these conditions changed in the VA healthcare system between 2000 and 2008. Using VA data, investigators identified inpatient, outpatient, and pharmacy utilization and costs for FY00 and FY08 for women Veterans in regards to 42 common health conditions, including cancer, infectious disease (HIV/AIDS), neurological disease (i.e., stroke, spinal cord injury), and cardiovascular disease (i.e., hypertension, ischemic heart disease). They also examined female gender-specific conditions, such as pregnancy, infertility, breast cancer, and cancer of the female reproductive organs. Investigators estimated the costs of each condition.
FINDINGS:
- The number of women Veterans treated in the VA healthcare system increased from 156,305 in 2000 to 266,978 in 2008; 88% of these women were under 65 years of age.
- The mean costs of care increased from $4,962 per woman Veteran in FY00 to $6,570 in FY08. Gender-specific, cancer, musculoskeletal, and mental health and substance abuse conditions accounted for a greater share of overall costs during the study period.
- Psychiatric conditions represented the largest share of costs for female VA patients during the study years. There was a modest rise in costs for psychiatric conditions among all female Veteran patients driven by the growing number of women treated for depression and PTSD. From 2000 to 2008, the proportion of women treated for PTSD increased by 133%, while the proportion of women treated for depression increased by 41%.
LIMITATIONS:
- Conditions not included in this study accounted for 23% of costs in women Veterans.
- Methods used in this study were based on the assumption that patients received care for health conditions recorded in encounters; however, it is possible that patients did not receive care for some diagnosed conditions, so that the cost of a condition could be overstated.
IMPLICATIONS:
Increases in depression, PTSD, and other psychiatric conditions, and tobacco and other substance use disorders point to the need for ready access to mental and behavioral healthcare services, possibly targeted toward women. In addition, the high rates and treatment costs of painful conditions (i.e., arthritis, low back pain) among women suggest that management of these conditions should be a target area for comparative effectiveness analyses of competing treatment strategies.
AUTHOR/FUNDING INFORMATION:
Partial support was provided by the Women Veterans Health Strategic Health Care Group. Drs. Yoon and Phibbs are part of HSR&D's Health Economics Resource Center in Palo Alto, CA. Drs. Yoon, Phibbs and Frayne are part of HSR&D's Center for Health Care Evaluation, Palo Alto, CA.
Yoon J, Scott JY, Phibbs CS, and Frayne SM. Trends in Rates and Attributable Costs of Conditions among Female VA Patients, 2000 and 2008. Women’s Health Issues May 2012;22(3):e337-344.
