Most Veterans with Military Sexual Trauma Report High Satisfaction with VA Outpatient Care
BACKGROUND:
Military sexual trauma (MST) is reported by approximately 22% of female Veterans and 1% of male Veterans who use the VA healthcare system. In civilian health care settings, women who have experienced sexual trauma have reported poorer satisfaction with health care services and poorer patient provider communication, as compared to women who have not experienced sexual trauma. However, few studies have investigated the relationship between patients’ perceptions of healthcare quality and MST in settings with comprehensive policies surrounding MST detection and treatment, such as VA. This cross-sectional study examined the association of MST to patient satisfaction with VA outpatient care. Investigators used a nationally representative sample of VA outpatients, which included 5,758 female Veterans and 158,884 male Veterans who had completed the Survey of Healthcare Experiences of Patients (SHEP) Ambulatory Care between 12/06 and 12/07 – and who had been screened for MST. Measures included: MST status, patients’ ratings of overall satisfaction with VA care in the previous two months, and nine other dimensions of patient satisfaction (e.g., continuity, access, coordination, education and information, specialist care). Demographics, health status, and healthcare services utilization also were assessed.
FINDINGS:
- Veterans’ ratings of overall satisfaction with VA outpatient care (regardless of MST status) were high. The proportion of patients reporting very good or excellent overall satisfaction was 79% for male Veterans and 72% for female Veterans.
- After adjusting for patient characteristics, male and female Veterans’ MST status was not associated with satisfaction ratings of overall VA healthcare. However, female Veterans with a history of MST rated the patient satisfaction dimensions of overall coordination, as well as education and information, less favorably than female Veterans without a history of MST.
LIMITATIONS:
- Investigators did not measure satisfaction with specific MST-related mental health services. They also were unable to measure other types of non-military sexual trauma that may have had an effect on ratings of patient satisfaction with VA outpatient care.
- These exploratory analyses represent the first examination of MST and patient perceptions of quality. Additional work is needed to determine whether these findings are specific to MST, or are a function of more complex medical and mental health comorbidities common among patients who report MST.
NOTE: Portions of this study were previously reported to VA’s Office of Mental Health Services.
AUTHOR/FUNDING INFORMATION:
All authors, except Dr. Valdez, are part of VA’s National Center for Post-traumatic Stress Disorder, VA Palo Alto Health Care System, and Dr. Kimerling is also part of HSR&D’s Center for Health Care Evaluation, Palo Alto, CA. This report was funded by VA’s Office of Mental Health Services Military Sexual Trauma Support Team, with additional research funding from the National Center for PTSD.
Kimerling R, Pavao J, Valdez C, et al. Military Sexual Trauma and Patient Perceptions of Veterans Health Administration Healthcare Quality. Women’s Health Issues July 2011;21(4, Supplement):S145-151.
