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Study Examines Barriers to Healthcare Access for Women Veterans

In 2010, VA embarked on a system-wide transformation that aims to provide all Veterans with timely access to quality healthcare in a Veteran-centered manner. Expanding healthcare access for women Veterans is one of the top three strategic initiatives in this transformation. However, it is unknown how general and Veteran-specific determinants of VA healthcare use impact overall receipt of needed healthcare. This study examined the association of general and Veteran-specific barriers on access to healthcare among women Veterans. Using data from the National Survey of Women Veterans (national telephone survey conducted 2008-09), investigators identified 3,608 women Veterans who provided information regarding delayed healthcare or unmet healthcare need in the prior 12 months. Independent variables that were examined included: socio-demographics, insurance status, overall health status, disability, and diagnosed mental health conditions.


  • Overall, almost 1 in 5 women Veterans (19%) delayed healthcare or went without needed care in the prior 12 months, including 14% of insured and 55% of uninsured women Veterans. VA healthcare users comprised 21% of those with and 13% of those without delayed healthcare or unmet needs.
  • Younger age groups were associated with a higher prevalence of delayed care or unmet need: 36% of 18-34 yr-olds; 29% of 35-49 yr-olds; 16% of 50-64 yr-olds; and 7% of 65+ yr-olds.
  • Among women Veterans delaying or going without care, barriers that varied by age group were: unaffordable healthcare (63% of 18-34 vs. 12% of 65+ age groups); inability to take time off work (39% of those younger than age 50); and transportation difficulties (36% of those age 65+).
  • A higher percentage of women with delayed care or unmet need, compared to those without, were racial/ethnic minorities, lacked a regular source or provider of healthcare, were uninsured, had low income, fair or poor health status, were disabled, and had mental health diagnoses.
  • With respect to Veteran-related factors, women Veterans with delayed care or unmet need were more likely than those without to be OEF/OIF Veterans, in a high-priority group for VA enrollment, and to have experienced military sexual assault.


  • Investigators did not assess the seriousness of the condition for which healthcare was delayed or not obtained, the length or number of delays over 12 months, or the health consequences.
  • In this sample, there may have been under-coverage of Veterans without a telephone – a group likely to have significant access to healthcare barriers.

This study was partly funded by HSR&D (SDR 08-270). Dr. Yano was also supported by an HSR&D Research Career Scientist Award, and Dr. Bean-Mayberry was supported by an HSR&D Career Development Transition Award. All authors are part of HSR&D’s Center for the Study of Healthcare Provider Behavior.

PubMed Logo Washington DL, Bean-Mayberry B, Riopelle D, and Yano EM. Access to Care for Women Veterans: Delayed Healthcare and Unmet Need. Journal of General Internal Medicine 2011 Nov;26 Suppl 2:655-61.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.