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. 2011 Nov;26 Suppl 2(Suppl 2):655-61.
doi: 10.1007/s11606-011-1772-z.

Access to care for women veterans: delayed healthcare and unmet need

Donna L Washington  1 , Bevanne Bean-Mayberry, Deborah Riopelle, Elizabeth M Yano
Affiliations

Access to care for women veterans: delayed healthcare and unmet need

Donna L Washington et al. J Gen Intern Med. 2011 Nov.

Abstract

Background: Timely access to healthcare is essential to ensuring optimal health outcomes, and not surprisingly, is at the heart of healthcare reform efforts. While the Veterans Health Administration (VA) has made improved access a priority, women veterans still underutilize VA healthcare relative to men. Eliminating access disparities requires a better understanding of the barriers to care that women veterans' experience.

Objective: We examined the association of general and veteran-specific barriers on access to healthcare among women veterans.

Design and participants: Cross-sectional, population-based national telephone survey of 3,611 women veterans.

Main measure: Delayed healthcare or unmet healthcare need in the prior 12 months.

Key results: Of women veterans, 19% had delayed healthcare or unmet need, with higher rates in younger age groups (36%, 29%, 16%, 7%, respectively, in 18-34, 35-49, 50-64, and 65-plus age groups; p < 0.001). Among those delaying or going without care, barriers that varied by age group were: unaffordable healthcare (63% of 18-34 versus 12% of 65-plus age groups); inability to take off from work (39% of those <50); and transportation difficulties (36% of 65-plus). Controlling for age, race/ethnicity, regular source of care, and health status, being uninsured (OR = 6.5; confidence interval [CI] 3.0-14.0), knowledge gaps about VA care (OR = 2.1; 95% CI 1.1-4.0), perception that VA providers are not gender-sensitive (OR = 2.4; CI 1.2-4.7), and military sexual assault history (OR = 2.1; CI 1.1-4.0) predicted delaying or foregoing care, whereas VA use and enrollment priority did not.

Conclusions: Both general and veteran-specific factors impact women veterans' access to needed services. Many of the identified access barriers are potentially modifiable through expanded VA healthcare and social services. Health reform efforts should address these barriers for VA nonusers. Efforts are also warranted to improve women veterans' knowledge of availability and affordability of VA healthcare, and to enhance the gender-sensitivity of this care.

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References

    1. Department of Veterans Affairs. Veterans Health Care: Leading the Way to Excellence. Universal Services Task Force Report. Washington, DC: Department of Veterans Affairs; Feb. 2009.
    1. Department of Veterans Affairs, Office of Public and Intergovernmental Affairs. President Obama’s 2010 Spending Plan Initiates Transformation for VA Services. Available at: http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1671, or http://www.prnewswire.com/news-releases/president-obamas-2010-spending-p.... Accessed June 8, 2011.
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    1. Department of Veterans Affairs. Provision of Primary Care to Women Veterans. Report of the Under Secretary for Health Workgroup. Washington, DC: Department of Veterans Affairs; Nov. 2008.

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