Sufficiency of VA Resources for the Delivery of Health Care to Women Veterans

Washington DL, Goldzweig C, Simon B, Caffrey C, Canelo I, Turner C, Yano EM. Sufficiency of VA Resources for the Delivery of Health Care to Women Veterans. Paper presented at: VA HSR&D National Meeting; 2002 Feb 1; Washington, DC.

Objectives: Despite increased numbers of women veteran users, little is known about health services delivery to women across the VA. Our objective was to assess availability of common women's health services, and existing resource needs and service gaps. Methods: We conducted a nationwide survey of all 166 VA facilities that delivered outpatient care to 400 or more female veterans in fiscal year 2000. The survey respondent was the senior clinician identified by the chief-of-staff as the person most knowledgeable about and/or responsible for the delivery of women's health care at that site. We assessed the availability, either on-site or through other arrangements (including fee basis), of 13 services required for comprehensive primary care of women, and of prenatal care. To assess needs, we asked about sufficiency of resources, personnel, clinical expertise, and privacy arrangements. Results: The response rate was 80% (n = 133). 39% of respondents reported on-site availability of 12 or more of 13 services assessed. All but 1 respondent offered pelvic examinations on-site. 10% of respondents did not offer urine pregnancy tests on-site, and this included 2.3% who reported unavailability of the test through other arrangements. Prenatal care is offered on-site at 9% of facilities, through other arrangements by 86%, and is unavailable at 4%. Resources for delivering care to women veterans have increased during the past two years at 56% of sites, but decreased at 12%. 30% of respondents reported having sufficient resources in 12 or more of 13 areas assessed. 7% lacked sufficient curtains in exam rooms for maintaining patient privacy. 21% of sites did not have a provider on-site with training or experience in treating women veterans with PTSD related to sexual trauma. The correlation between service availability and adequacy of resources was 0.21 (p = .016). Conclusions: The VA is responding to the growth in the number of female veterans by targeting resources and services to meet their unique health care needs. However, identified service gaps and resource needs still exist. Impact statement: These data may help inform the debate on where to direct resources to meet the health needs of women veterans. Correlation with patient satisfaction and other outcome measures is underway.