HSR&D Citation Abstract
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Current Health Care Use by Reserve and National Guard Servicewomen with Varied Deployment and Trauma Exposures
Mengeling M, Sadler AG, Booth B, Torner J. Current Health Care Use by Reserve and National Guard Servicewomen with Varied Deployment and Trauma Exposures. Poster session presented at: AcademyHealth Annual Research Meeting; 2011 Jun 12; Seattle, WA.
Identify associations between current health services utilization, Military Sexual Trauma (MST) and deployment in Reserve/National Guard (RNG) servicewomen.
A cross-sectional study of RNG servicewomen by deployment experience: never deployed, deployed to Iraq or Afghanistan (I/A) once; deployed to I/A more than once; deployed elsewhere. Random sampling within deployment category was carried out until 665 interviews were completed (70% response rate). The computer-assisted telephone interview assessed socio-demographic variables, trauma exposures, health history, current health status, and healthcare utilization.
Population StudiedRNG servicewomen from five Midwestern states who served after Oct. 2001 (i.e., Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) service era).
Principal FindingsMedian age of participants was 37 years (range 19-66). Over half (52%) had deployed to Iraq or Afghanistan (I/A) at least once, 27% were deployed elsewhere, and 22% had never deployed. Forty percent of participants reported at least one lifetime sexual assault with 18% acknowledging MST. Women who experienced MST were less likely to report assault during deployment (28%, n = 34). Almost two-thirds (61%) reported currently having a non-VA Primary Care Provider (PCP); a fifth (21%) reported having no PCP; 12% reported a VA PCP solely; and 6% both non-VA and VA PCPs. In the past year, 83% had a routine physical exam, 74% had specific physical health appointments, and 22% had at least 1 mental health appointment. RNG servicewomen who experienced MST were more likely to report at least one visit in the past year for specific physical health concerns (20% v. 12%, p = .02) than those who did not experience MST. There were no significant differences in number of routine physical exams by deployment status (p = .07) or MST (p = .08).Women deployed to I/A were significantly more likely to have a mental health appointment (28% v 15%, p < .01) during the past year as were those with MST (37% v 18%, p < .01). The majority of mental health care users (71%, n = 101) had at least one appointment at a non-VA facility.
In summary, we found that MST is associated with greater use of physical and mental healthcare while deployment experience is associated with greater use of mental healthcare. Current RNG mental healthcare users tend to seek care outside the VA system.
Implications for Policy, Delivery or Practice
Non-VA primary and mental healthcare providers may be providing the majority of care to RNG servicewomen. RNG servicewomen have unique combat and MST exposures that influence their health care use. Women seeking VA care are routinely screened for MST and deployment history. Non-VA clinicians should also routinely assess military service history and consequent MST and combat exposures in order to address the care needs of this unique population. Further research is needed to determine if there are differences in RNG servicewomen's health care outcomes associated with VA vs Non-VA care use.