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National Survey of Women Veterans: Improving Care and Understanding Needs

This study aims to identify the current status, demographics, VA experiences, and healthcare needs of women veterans in a national sample. It also seeks to determine how their healthcare needs differ based on military service period and assess their preferences to address barriers to VA healthcare use.

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National Survey of Women Veterans: Improving Care and Understanding Needs

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  1. VA HSR&D Center for the Study of Healthcare Provider Behavior The National Survey of Women Veterans Enhancing Research-Clinical Partnerships for Improving the Care of Women Veterans Donna L. Washington, MD, MPH VA Greater Los Angeles HSR&D Center of Excellence UCLA School of Medicine VA Women’s Health Services Research Conference Arlington VA  July 15, 2010

  2. Background • The only prior national survey of women veterans was conducted 25 years ago – 1985 Survey of Female Veterans • Women’s military roles, experiences, and needs have changed dramatically • Current data needed for evidence-based strategic planning for programs and services for women veterans

  3. National Survey of Women Veterans Objectives • Identify in a national sample, the current status, demographics, VA experiences, and health care needs of women veterans • Determine how health care needs and barriers to VA health care use differ by period of military service • Assess women veterans’ health care preferences in order to address VA barriers and health care needs

  4. Methods • Telephone survey fielded in 2008-09 • National population-based stratified random sample of women veterans • Stratification on military service period (pre-Vietnam, OEF/OIF, all other periods) and VA use (VA user, VA nonuser) • Over-sampled VA users, pre-Vietnam era and OEF/OIF military cohorts • 3,611 participants (86% of eligible) • Analyses weighted to represent U.S. women veteran population

  5. Measures • Demographic characteristics • Health status and personal health behaviors • VA and non-VA health care use • Knowledge and perceptions of VA health care • Determinants of and barriers to VA health care use

  6. Demographics: Age distribution U.S. Women Veterans n=1,802,000from population projection models 27% 22% 17% 14% 6% 6% 5% 3% Age group in years

  7. Demographics: Ethnicity & Race

  8. Health care use in prior 12 months * *p<0.05 vs. other military cohorts

  9. Health Status and Prevalence of Chronic conditions* Post- Traumatic Stress Disorder Anxiety disorder Health fair or poor > 3 diagnosed medical conditions Depression *all p< .0005

  10. Chronic disease Risk Factors * * * Inadequate exercise Obesity (BMI > 30) Tobacco use Hypertension Hazardous alcohol use * p<.05

  11. Types of Health Care Services Used in Prior 12 Months* *Not mutually exclusive

  12. Post-partum attrition from VA Timeframe for return to VA health care among those using VA at time of pregnancy (n=546) Returned within 1 year 57% Did not go back 30% 14% Returned after 1 year

  13. Barriers to using VA health care among Women Veterans who considered, but did not use, VA* *Not mutually exclusive

  14. Knowledge of VA services • 39% have none or almost none of needed information about VA • Misperceptions in all cohorts about who is eligible for VA health care • OEF/OIF more knowledgeable than other cohorts about available women’s health and readjustment counseling services

  15. Influences on perceptions Perceptions of VA health care all p<.0001

  16. Conclusions and Implications • Population demographics highlights need for VA services that are gender, age, and culturally appropriate • Reproductive health; long-term care • High rates of cardiovascular and other chronic disease risk factors, particularly among VA users • Address prevention to delay onset of complex chronic conditions • Monitor risk reduction efforts by gender

  17. Implications: Access to Care • Targeted care coordination • General medical care, women’s health and mental health • Prenatal and postpartum services • Geographic planning models to identify Women Veteran populations and develop appropriate service delivery arrangements

  18. Implications: Outreach • Outreach and education to improve knowledge for all Women Veterans of VA benefits, eligibility, & services • Dissemination of accurate information to public and military about high quality of VA health care

  19. Research Team: Bevanne Bean-Mayberry, MD, MHS Elizabeth M. Yano, PhD, MSPH Michael N. Mitchell, PhD Mark Canning, BA Deborah Riopelle, MPH Su Sun, MPH Mingming Wang, MPH Julia Yosef, MS Funding: VA Office of Public Health and Environmental Hazards, Women Veterans Health Strategic Healthcare Group & VA HSR&D SDR-08-270

  20. Three military cohorts in National Survey of Women Veterans • Pre-Vietnam Era: Military service ended prior to start of Vietnam Era • Vietnam Era to present (non-OEF/OIF): Any service since start of Vietnam Era (including post-9/11), except OEF/OIF • OEF/OIF: Military service in Operation Enduring Freedom or Operation Iraqi Freedom • Subset of those with post-9/11 service • Many also served prior to 9/11

  21. Three Military Cohorts in National Survey of Women Veterans Vietnam Era to present, no OEF/OIF service mean 82 yr mean 53 yrmean 38 yr Pre-Vietnam OEF/OIF service 9/11/01 1941 9/30/08 8/5/1964 End date of military service // NSWV

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