FACTORS THAT IMPACT FEMALE VETERAN UTILIZATION OF VETERANS HEALTH ADMINISTRATION
Loading...
Links to Files
Permanent Link
Author/Creator
Author/Creator ORCID
Date
2020-01-20
Type of Work
Department
School of Public Policy
Program
Public Policy
Citation of Original Publication
Rights
Distribution Rights granted to UMBC by the author.
This item may be protected under Title 17 of the U.S. Copyright Law. It is made available by UMBC for non-commercial research and education. For permission to publish or reproduce, please see http://aok.lib.umbc.edu/specoll/repro.php or contact Special Collections at speccoll(at)umbc.edu
This item may be protected under Title 17 of the U.S. Copyright Law. It is made available by UMBC for non-commercial research and education. For permission to publish or reproduce, please see http://aok.lib.umbc.edu/specoll/repro.php or contact Special Collections at speccoll(at)umbc.edu
Subjects
Abstract
The Background There are approximately 19.9 million veterans who served the country across the nation, comprising about 6.1% of the U.S. population (National Center for Veteran Analysis and Statistics, 2018 and U.S. Census Bureau, 2018). There are currently 14.5 million veterans who are eligible to receive VA health care services. Although 72.9% of total veterans are eligible for VA health care, only 45% are actually enrolled to receive services (National Center for Veteran Analysis and Statistics, 2018). Little is known about the factors that impact the personal decisions of enrolled women veterans to choose VA health care instead of private health care services. Nor are the factors that influence women veterans? use of private health care, despite eligibility and enrollment in VA health services, well understood. Currently, women comprise 9-10% of the total veteran population (Women Veterans Report, 2015) and according to population model estimates, the share of women veterans is expected to double to 18% by 2025 (Women Veterans Report, 2015). Anticipating the health care needs for the forecasted growth of veteran women should include the anticipation of unintended consequences of those who slip through the cracks of care and extreme outcomes, such as suicide (Washington, 2007). Prior literature and work about the preferences and decision-making about VA health care use inspired this study. Specifically, I sought to understand the decisions to not use VA health care when women have access to other coverage and learned the decision may not solely be about access to other health insurance, but may be related to trust in VA as a system. Research Methods By analyzing the socioeconomic, enabling and need characteristics of veteran women who are enrolled in VA health care services, this study examines the variables that impact their current and planned patterns of utilization of VA health services. Descriptive statistics summarize the study sample. Findings of the analysis of the logistic regression related to prior year use and multinominal logistic regression models for outcomes related to level of use and anticipated future use are discussed. Data The data for this study comes from information presented in the VA Survey of Veteran Enrollees? Health and Use of Health Care (SOE). The SOE is an annual survey that allows veterans to self-report on their personal demographics, patterns of current and planned utilization of VA health services, and information about additional health care coverage. The results of the survey inform annual VHA projections of enrollment, utilization, and expenditures and various budget and policy related analyses. Findings The availability of health insurance coverage, in addition to eligibility for the VA, veteran women'sVA Priority status and their level of trust in the VA, were the most consistent factors associated with use. Veteran women with other sources of coverage and lower priority status had lower levels of use, and they anticipated future use in specific ways, such as a safety net, relative to as a primary source of care. Increasing levels of trust in the VA were associated with greater use of VA services. Policy Implications The research findings give insight to the current utilization, level of use of VA services, and planned ways for future use among veteran women. The VA could leverage these findings to direct communication tactics, not only between the VA and veteran women patients but also information sharing among organizations that have contact with veteran women (Washington, 2007). The data also support opportunities for greater communication and collaboration between VA and public sector agencies that provide health insurance coverage and medical facilities. Increasing education about VA initiatives and benefits, through direct patient communication and indirect communication, via collaboration with other public sector organizations, could increase trust in VA among veteran women. Increasing cultural competence about military culture could also be a training opportunity for care in the community contracts and affiliations. Recent legislation such as the Veterans Access, Choice, and Accountability Act of 2014 and the MISSION Act were created with objectives to increase care in the community and coordination of services to best serve veterans. Although these laws and subsequent initiatives would help alleviate the physical barriers to access for veterans who lived 40 miles or more from the nearest VA medical center, studies have shown that there are other cultural obstacles. A greater focus should be on the perceived barriers for women veterans and reasons for not choosing VA health care services, even when they are eligible for and enrolled in VA health care system. Research has shown that there are lower rates of suicide among female veterans who use VA health care services (Hoffmire, et al., 2015; Veterans Affairs, 2014). Understanding patterns of utilization may be key to decreasing rates of suicide rates among veteran women and findings from this study could influence policy to implement military cultural competence about suicide risks for veteran women across organizations that partner with VA.