Comparison of outpatient health care utilization among returning women and men veterans from Afghanistan and Iraq
Duggal, Mona ; Goulet, Joseph L. ; Womack, Julie ; Gordon, Kirsha ; Mattocks, Kristin M ; Haskell, Sally G. ; Justice, Amy C. ; Brandt, Cynthia A.
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Keywords
Afghan Campaign 2001-
Ambulatory Care Facilities
Cohort Studies
Female
Humans
Iraq War, 2003-2011
Male
Retrospective Studies
United States
*Veterans
Veteran Administration Health
Private Health Insurance
Incident Rate Ratio
Veteran Administration
Health Care Service Utilization
Gender and Sexuality
Health Services Administration
Health Services Research
Military and Veterans Studies
Women's Health
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Abstract
BACKGROUND: The number of women serving in the United States military increased during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), leading to a subsequent surge in new women Veterans seeking health care services from the Veterans Administration (VA). The objective of this study was to examine gender differences among OEF/OIF Veterans in utilization of VA outpatient health care services.
METHODS: Our retrospective cohort consisted of 1,620 OEF/OIF Veterans (240 women and 1380 men) who enrolled for outpatient healthcare at a single VA facility. We collected demographic data and information on military service and VA utilization from VA electronic medical records. To assess gender differences we used two models: use versus nonuse of services (logistic regression) and intensity of use among users (negative binomial regression).
RESULTS: In our sample, women were more likely to be younger, single, and non-white than men. Women were more likely to utilize outpatient care services (odds ratio [OR] = 1.47, 95% confidence interval [CI]:1.09, 1.98), but once care was initiated, frequency of visits over time (intensity) did not differ by gender (incident rate ratio [IRR] = 1.07; 95% CI: 0.90, 1.27).
CONCLUSION: Recently discharged OEF/OIF women Veterans were more likely to seek VA health care than men Veterans. But the intensity of use was similar between women and men VA care users. As more women use VA health care, prospective studies exploring gender differences in types of services utilized, health outcomes, and factors associated with satisfaction will be required.
Source
BMC Health Serv Res. 2010 Jun 22;10:175. doi: 10.1186/1472-6963-10-175. Link to article on publisher's site
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Notes
At the time of publication, Kristin Mattocks was not yet affiliated with the University of Massachusetts Medical School.