Ouimette Paige, Wolfe Jessica, Daley Jennifer, Gima Kristian
Washington Institute for Mental Illness Research and Training, Washington State University, Spokane, USA.
Women Health. 2003;38(2):77-91. doi: 10.1300/J013v38n02_06.
The Department of Veterans Affairs (VA) has a Congressional mandate but few empirical data on which to design and improve national health care services for women. We examined characteristics associated with women's current, former and non-use of the VA health care system. The study included 1,500 female veterans sampled from the Department of Veterans Affairs National Registry of Women Veterans. Women completed a 45-minute telephone survey assessing multiple domains of functional status and health service use. Using multivariate logistic regression, use of VA health care was associated with older age, more education, not being married, lower rates of insurance coverage, and poorer physical and psychological health. Women who were former users of VA health care were more likely to be ethnic minorities, have children, served less time in the military, had higher rates of insurance coverage and better physical and psychological health than current users. Prominent military experiences (e.g., service in a war-zone, exposure to trauma) were associated with former use and never using the VA health care system. Women who use VA health care are at greater economic, social, and health risk than nonusers, factors that have personal implications for the veteran as well as cost and service implications for VA. Additional research is needed to better understand the role of military experiences in women veterans' choice of health care.
美国退伍军人事务部（VA）有一项来自国会的任务，但却缺乏用以设计和改进针对女性的全国性医疗服务的实证数据。我们研究了与女性当前、曾经使用及未使用退伍军人事务部医疗系统相关的特征。该研究从退伍军人事务部女性退伍军人国家登记处抽取了1500名女性退伍军人作为样本。女性完成了一项45分钟的电话调查，评估功能状态和医疗服务使用的多个领域。使用多变量逻辑回归分析发现，使用退伍军人事务部医疗服务与年龄较大、受教育程度较高、未婚、保险覆盖率较低以及身体和心理健康状况较差有关。曾经使用过退伍军人事务部医疗服务的女性比当前使用者更有可能是少数族裔、育有子女、服役时间较短、保险覆盖率较高且身体和心理健康状况更好。突出的军事经历（例如，在战区服役、接触创伤）与曾经使用及从未使用退伍军人事务部医疗系统有关。使用退伍军人事务部医疗服务的女性比未使用者面临更大的经济、社会和健康风险，这些因素对退伍军人个人有影响，同时对退伍军人事务部的成本和服务也有影响。需要进行更多研究以更好地理解军事经历在女性退伍军人医疗保健选择中的作用。
