Study Examines Barriers to Healthcare Access for Women Veterans
BACKGROUND:
In 2010, VA embarked on a system-wide transformation that aims to provide all Veterans with timely access to quality healthcare in a Veteran-centered manner. Expanding healthcare access for women Veterans is one of the top three strategic initiatives in this transformation. However, it is unknown how general and Veteran-specific determinants of VA healthcare use impact overall receipt of needed healthcare. This study examined the association of general and Veteran-specific barriers on access to healthcare among women Veterans. Using data from the National Survey of Women Veterans (national telephone survey conducted 2008-09), investigators identified 3,608 women Veterans who provided information regarding delayed healthcare or unmet healthcare need in the prior 12 months. Independent variables that were examined included: socio-demographics, insurance status, overall health status, disability, and diagnosed mental health conditions.
FINDINGS:
- Overall, almost 1 in 5 women Veterans (19%) delayed healthcare or went without needed care in the prior 12 months, including 14% of insured and 55% of uninsured women Veterans. VA healthcare users comprised 21% of those with and 13% of those without delayed healthcare or unmet needs.
- Younger age groups were associated with a higher prevalence of delayed care or unmet need: 36% of 18-34 yr-olds; 29% of 35-49 yr-olds; 16% of 50-64 yr-olds; and 7% of 65+ yr-olds.
- Among women Veterans delaying or going without care, barriers that varied by age group were: unaffordable healthcare (63% of 18-34 vs. 12% of 65+ age groups); inability to take time off work (39% of those younger than age 50); and transportation difficulties (36% of those age 65+).
- A higher percentage of women with delayed care or unmet need, compared to those without, were racial/ethnic minorities, lacked a regular source or provider of healthcare, were uninsured, had low income, fair or poor health status, were disabled, and had mental health diagnoses.
- With respect to Veteran-related factors, women Veterans with delayed care or unmet need were more likely than those without to be OEF/OIF Veterans, in a high-priority group for VA enrollment, and to have experienced military sexual assault.
LIMITATIONS:
- Investigators did not assess the seriousness of the condition for which healthcare was delayed or not obtained, the length or number of delays over 12 months, or the health consequences.
- In this sample, there may have been under-coverage of Veterans without a telephone – a group likely to have significant access to healthcare barriers.
AUTHOR/FUNDING INFORMATION:
This study was partly funded by HSR&D (SDR 08-270). Dr. Yano was also supported by an HSR&D Research Career Scientist Award, and Dr. Bean-Mayberry was supported by an HSR&D Career Development Transition Award. All authors are part of HSR&D’s Center for the Study of Healthcare Provider Behavior.
Washington DL, Bean-Mayberry B, Riopelle D, and Yano EM. Access to Care for Women Veterans: Delayed Healthcare and Unmet Need. Journal of General Internal Medicine 2011 Nov;26 Suppl 2:655-61.
