VA Healthcare for Women Veterans: Medical Care Supplement
BACKGROUND:
Women are entering the military in record numbers and currently comprise 20% of new recruits; by 2018, it is estimated that they'll comprise 10% of the Veteran population. To support the healthcare needs of women Veterans, VA supports a comprehensive women's health research agenda. In an editorial written by VA HSR&D investigators Lori Bastian and colleagues, the authors provide an overview of the Medical Care Supplement "Informing Policy to Deliver Comprehensive Care for Women Veterans," which was supported by VA HSR&D. The goal of this Supplement is to disseminate new research findings related to the planning, organization, financing, provision, evaluation, and improvement of health services and/or outcomes for women Veterans and women actively serving in the military. In addition to 21 articles, the Supplement features several editorials that describe emerging areas of women's health research, particularly following the 2014 Veterans Choice Act, as well as a partnered-research initiative that aims to accelerate the implementation of comprehensive care for women Veterans. Following are just some of the study findings in this Supplement.
SUMMARY FINDINGS:
- Kimerling and colleagues describe women Veterans' needs for mental health services and resources in the VA healthcare system. Findings show that among women using VA primary care, half reported a need for mental health services and more than three-quarters received such care.
- Maisel and colleagues evaluated VA primary care readiness for delivering comprehensive women's healthcare through staffing with designated women's health providers (DWHPs). Findings show that new female primary care patients were less likely to see a DWHP than established patients, while Bean-Mayberry and colleagues found that Veterans seeing DWHPs had higher odds of receiving breast and cervical cancer screening.
- Colonna and colleagues evaluated demographics and breast cancer characteristics of more than 4,000 women Veterans who were enrolled in VA healthcare and who were diagnosed with breast cancer between 1995 and 2012. Findings show that cases of breast cancer per year have increased over time, but the fraction of breast cancers that were node negative has increased from 45% in 1995-1999 to 64% in 2010-2012.
- Iverson and Pogoda examined the relationship between experience with intimate partner violence (IPV) and traumatic brain injury (TBI) and found that about one-fifth of women Veterans exposed to IPV met screening criteria for a history of TBI.
- Friedman and colleagues examined the distance women Veterans travel to receive VA care. Longer driving time was associated with higher attrition. The relationship between driving time and attrition was stronger among new patients, and was not modified by living in a rural setting.
- Mattocks and colleagues analyzed the prevalence of infertility diagnoses and treatment rates among OEF/OIF/OND women Veterans using VA healthcare and found that fewer than 2% had been diagnosed with infertility problems. Of those Veterans, only 22% received infertility assessment or treatment; overall, 39% received this type of care from non-VA providers.
- Foynes and colleagues conducted a longitudinal study of 471 Marine recruits from 1997 to 2008 (35% white men, 38% white women, 13% racial/ethnic minority men, 15% racial/ethnic minority women) and found that more than a decade after the original study, experiences of race-based (but not sex-based) discrimination were negatively associated with physical health and self-esteem.
Women Veterans’ Health and Health Care. Medical Care April 2015;53(Suppl 4):S1-164.