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Racial-Ethnic Variations in Women Veterans’ Healthcare Use

Farmer MM, Rose DE, Yano EM, Washington DL. Racial-Ethnic Variations in Women Veterans’ Healthcare Use. Paper presented at: VA HSR&D Enhancing Partnerships for Research and Care of Women Veterans Conference; 2014 Jul 31; Arlington, VA.


Background: With implementation of the Affordable Care Act comes new healthcare options for Americans, including Veterans who may or may not rely on the VA healthcare system. Little is known about the extent to which U.S. women Veterans access health care and, if so, the extent to which they rely on VA for their health services. Women Veterans are also more likely to be racial-ethnic minorities, which may change the odds of their access and use outside the VA based on current patterns of insurance and usual sources of care. We examined racial-ethnic variations in women Veterans' healthcare use and reliance on the VA for their care. Methods: Data came from the National Survey of Women Veterans, a cross-sectional, national population-based telephone survey of 3,611 women Veterans (results weighted to the US women Veteran population). We used logistic regression to examine the relationship of race-ethnicity to recent (past year) healthcare use. Among healthcare users, we used weighted logistic regression to examine the independent predictors of VA reliance (VA-only, dual VA and non-VA, non-VA only) controlling for patient-level characteristics. Results: Almost all women Veterans (90%) reported healthcare service use, with the majority of users (76%) relying on non-VA healthcare services only and 7% added VA to non-VA care. Only 7% of users relied solely on VA care. We found no racial-ethnic difference in recent use. Among users, however, non-Hispanic Black women had significantly greater odds of VA-only health services use (OR = 2.27 CI 1.18-4.36), and decreased odds of using only non-VA services (OR = 0.46 CI 0.24-0.90), compared to non-Hispanic White women. Lower income, being uninsured, being service-connected, and having served in OEF/OIF decreased the odds of non-VA use and increased the odds of VA-only use. Conclusions: In contrast to the non-Veteran population where racial-ethnic minorities are less likely to access care, we found no differences in use by race-ethnicity. However, the VA appears to have a special role in serving the needs of non-Hispanic Black women who were more likely to utilize VA services exclusively. Impact: The VA must be equipped to address health needs (e.g., hypertension, diabetes, obesity) of the increasingly racially-ethnically diverse women Veteran population.

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