Perspectives of VA healthcare from rural women veterans not enrolled in or using VA healthcare

PLoS One. 2023 Aug 14;18(8):e0289885. doi: 10.1371/journal.pone.0289885. eCollection 2023.

Abstract

Purpose: Women Veterans have unique healthcare needs and often experience comorbid health conditions. Despite this, many women Veterans are not enrolled in the Veterans Health Administration (VHA) and do not use VHA services. Underutilization of VHA services may be particularly prevalent among rural women Veterans, who may experience unique barriers to using VHA care. Nonetheless, knowledge of rural women Veterans and their experiences remains limited. We sought to understand rural women Veterans' perceptions and needs related to VHA healthcare, including barriers to enrolling in and using VHA services, and perspectives on how to communicate with rural women Veterans about VHA services.

Methods: Rural women Veterans were recruited through community engagement with established partners and a mass mailing to rural women Veterans not enrolled in or using VHA healthcare. Ten virtual focus groups were conducted with a total of twenty-nine rural women Veterans (27 not enrolled in VHA care and 2 who had not used VHA care in the past 5 years) in 2021. A thematic inductive analytic approach was used to analyze focus group transcripts.

Findings: Primary themes regarding rural women Veterans' perceptions of barriers to enrollment and use of VHA healthcare included: (1) poor communication about eligibility and the process of enrollment; (2) belief that VHA does not offer sufficient women's healthcare services; and (3) inconvenience of accessing VHA facilities.

Conclusion: Although VHA has substantially expanded healthcare services for women Veterans, awareness of such services and the nuances of eligibility and enrollment remains an impediment to enrolling in and using VHA healthcare among rural women Veterans. Recommended strategies include targeted communication with rural women Veterans not enrolled in VHA care to increase their awareness of the enrollment process, eligibility, and expansion of women's healthcare services. Creative strategies to address access and transportation barriers in rural locations are also needed.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Female
  • Health Services
  • Health Services Accessibility
  • Humans
  • United States
  • United States Department of Veterans Affairs
  • Veterans Health
  • Veterans*

Grants and funding

KF received funding from Veteran Health Administration's Office of Women's Health. This was funding received for an evaluation project, where there was no award number. The funder did not play a role in the study design, data collection and analysis or preparation of the manuscript. They did contribute to the agreement to publish findings. https://www.womenshealth.va.gov/.