Women Veterans Significantly More Likely than Male Veterans to Use Any Healthcare Up to One Year Post-Discharge
BACKGROUND:
The United States' post-9/11 operations in the Middle East have greatly impacted the wellbeing of U.S. servicemembers, including women Veterans who now comprise 1 in 6 post-9/11 Veterans. Formerly dominated by Vietnam Era or older male Veterans, the VA healthcare system has adapted to younger patients and to women's healthcare needs. Further, Congress enacted the Veterans Access, Choice, and Accountability Act of 2014 (Veterans' Choice Program), making it easier for Veterans to get appointments with non-VA providers. This study examined gender differences among a national sample of 9,566 Veterans in the use of VA and non-VA health services during the first 15 months of the transition from military to civilian life. In Fall 2016, study participants within approximately 90 days post-military separation provided baseline data and, one year later, completed a web-based survey. In addition to demographics, the survey asked about healthcare use. Questions also targeted housing (stable or unstable), social support, employment, and education, in addition to sleep quality, PTSD, anxiety, depression, and behavioral risk factors (e.g., smoking, drinking).
FINDINGS:
- Women Veterans were twice as likely as men to use any healthcare (VA or non-VA) immediately post-military and 84% more likely than men to do so a year later – but the use of VA care was comparable between men and women. There was no difference at baseline (within 90 days of separation) and only a 22% increase for women relative to men at one year.
- The use of the Veterans’ Choice Program was uncommon for both genders.
- While unstable housing was similar across genders (10% for women and 12% for men), women Veterans with unstable housing at military separation were less likely to use healthcare a year later, especially for the subgroup with mental/behavioral health issues.
- Sleep problems, anxiety, and depression were associated with healthcare use for both men and women following transition.
IMPLICATIONS:
- VA housing assistance services could be gender-tailored for the 10% or 12% of Veterans with unstable housing; this could be implemented via outreach in the first 15 months post-separation.
- Sleep problems, depression, and anxiety remain drivers of healthcare use; whether expert treatment is provided in the community is unknown and should be assessed.
LIMITATIONS:
- All data were self-reported.
- The separating cohort in Fall 2016 does not necessarily represent earlier cohorts.
AUTHOR/FUNDING INFORMATION:
This study was partly funded by HSR&D. Dr. Copeland is with the VA Central Western Massachusetts Healthcare System; Dr. Finley is with The Elizabeth Dole Center of Excellence for Veteran and Caregiver Research; and Dr. Vogt is with the VA Boston Healthcare System.
Copeland L, Finley E, Vogt D, Perkins D, and Nillni Y. Gender Differences in Newly Separated Veterans’ Use of Healthcare. American Journal of Managed Care. March 12, 2020.
