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2019 HSR&D/QUERI National Conference Abstract

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1012 — New Women Veterans' Use of VA and non-VA Healthcare

Lead/Presenter: Laurel Copeland,  VA Central Western Massachusetts
All Authors: Copeland LA (VA Central Western Massachusetts, Leeds), Finley EP (South Texas Veterans Health Care System, San Antonio), Vogt D (VA Boston Healthcare) Perkins (Penn State University, Clearinghouse for Military Family Readiness) Nillni YI (VA Boston Healthcare)

Women veterans face different challenges upon separating from the military than do their male counterparts. Women generally use more healthcare than men. A longitudinal survey study, The Veterans Metrics Initiative (TVMI), assessed psychosocial health and healthcare use as veterans moved through the transition from military to civilian life. This study examined gender differences in use of VA and non-VA healthcare services, and associated clinical, social and lifestyle risk factors. Understanding gender differences in healthcare utilization may reveal potential disparities and suggest points of intervention in the period from separation from military service through the first 15 months thereafter.

The multi-wave web-based survey collected self-reported measures from a national sample of newly separated military veterans leaving the military in fall 2016. Multivariable analysis weighted to represent the sampling frame examined the association between gender and self-reported healthcare utilization overall and in the Veterans Health Administration (VA).

In late 2016, 7201 veterans (16% women) within approximately 90 days of military separation provided baseline data; a year later they responded to a follow-up survey. Sleep, anxiety, and depression were important drivers of healthcare use following separation for all respondents. Women used healthcare more than men did but used VA healthcare equally. Women's use of VA healthcare, but not healthcare generally, was more likely when they were dealing with anxiety or depression. For women veterans, unstable housing immediately post-military correlated with less healthcare use a year later.

Women veterans were more likely to use healthcare both immediately post-military and a year later compared to men, but use of the VA was gender-neutral suggesting under-use of the VA by women. U.S. veterans separating from military service continue to seek care for symptoms of anxiety, depression, and sleep disturbance: the hallmarks of posttraumatic military-related stress. A dismaying but understandable finding was decreased use of healthcare for women veterans endorsing concern about losing their housing; this correlation was observed a year post-separation.

VA outreach to women veterans could be tailored to include highlighting housing assistance available in the VA, to help women address healthcare when basic needs such as shelter are threatened.