Comparing Cancer Screening Rates in VA Divisions with and without Women’s Health Clinics

Mohr DC, Stolzman KL, Osatuke K. Comparing Cancer Screening Rates in VA Divisions with and without Women’s Health Clinics. Poster session presented at: VA HSR&D Field-Based Women's Health Meeting; 2010 Jul 14; Washington, DC.

Related HSR&D Project(s)

• IIR 05-221 – Team Process and Performance in Primary Care

Objectives: The goal of the study was to examine if women Veterans were more likely to receive breast and cervical cancer screening in VA divisions that had a women's health clinic in addition to a regular primary care/medicine clinic. Methods: Using patient-level data from the 2007 External Peer Review Program (EPRP), we identified 3,532 Veterans with any breast cancer screening chart review and 2,243 Veterans with a cervical cancer screening chart review. We matched the quality indicator report to additional demographic data: marital status, age, service-connected disability, means test indicator, mental health utilization, and race. Because the cancer screening measures are examined for a two and three-year basis, we created a variable to indicate whether the division had a women's health clinic that was new (1 year or less of operations), established (2 years or more of operations), or did not have a clinic based on clinic appointment codes. This variable was connected to the corresponding division with a chart review. We modeled both types of cancer screening measures using nonlinear hierarchical models. Results: A high percentage of Veterans had a completed screening for breast cancer (86.6%) and cervical cancer (91.6%). Of the 593 divisions in the sample, 24% had an established women's health clinic, and 4% had a newer women's health clinic. Significant variables for breast cancer screening were: being married (Odds Ratio (OR) = 1.52)) and age (OR = 1.03). Veterans seen at a division with an established women's health clinic (OR = 1.43) or new women's health clinic (OR = 1.95) were more likely to receive breast cancer screening. For cervical cancer, age was significant (OR = .97) as well as divisions with an established women's health clinic (OR = 1.56). Conclusions: We found the majority of women Veterans received recommended cancer screenings. Veterans who made visits to divisions with an established women's health clinic were more likely to receive recommended cancer screenings. Impact: The presence of a women's health clinic may be associated with greater adherence to screening guidelines, which may be a reason to encourage more clinics to be created.