Frayne Susan M, Parker Victoria A, Christiansen Cindy L, Loveland Susan, Seaver Margaret R, Kazis Lewis E, Skinner Katherine M
Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, CA, USA.
J Gen Intern Med. 2006 Mar;21 Suppl 3(Suppl 3):S40-6. doi: 10.1111/j.1525-1497.2006.00373.x.
Male veterans receiving Veterans Health Administration (VA) care have worse health than men in the general population. Less is known about health status in women veteran VA patients, a rapidly growing population.
To characterize health status of women (vs men) veteran VA patients across age cohorts, and assess gender differences in the effect of social support upon health status.
Data came from the national 1999 Large Health Survey of Veteran Enrollees (response rate 63%) and included 28,048 women and 651,811 men who used VA in the prior 3 years.
Dimensions of health status from validated Veterans Short Form-36 instrument; social support (married, living arrangement, have someone to take patient to the doctor).
In each age stratum (18 to 44, 45 to 64, and > or =65 years), Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were clinically comparable by gender, except that for those aged > or =65, mean MCS was better for women than men (49.3 vs 45.9, P<.001). Patient gender had a clinically insignificant effect upon PCS and MCS after adjusting for age, race/ethnicity, and education. Women had lower levels of social support than men; in patients aged <65, being married or living with someone benefited MCS more in men than in women.
Women veteran VA patients have as heavy a burden of physical and mental illness as do men in VA, and are expected to require comparable intensity of health care services. Their ill health occurs in the context of poor social support, and varies by age.
接受退伍军人健康管理局（VA）护理的男性退伍军人的健康状况比普通人群中的男性更差。对于女性退伍军人VA患者这一快速增长的群体的健康状况，人们了解较少。
描述不同年龄组女性（与男性相比）退伍军人VA患者的健康状况，并评估社会支持对健康状况影响的性别差异。
数据来自1999年全国退伍军人入组者大型健康调查（应答率63%），包括28048名女性和651811名在过去3年中使用过VA服务的男性。
采用经过验证的退伍军人简短36项问卷来测量健康状况维度；社会支持（婚姻状况、居住安排、是否有人带患者去看医生）。
在每个年龄层（18至44岁、45至64岁以及≥65岁），身体成分总结（PCS）和精神成分总结（MCS）得分在性别上具有临床可比性，但对于≥65岁的人群，女性的平均MCS得分高于男性（49.3对45.9，P<0.001）。在调整年龄、种族/民族和教育程度后，患者性别对PCS和MCS的影响在临床上不显著。女性的社会支持水平低于男性；在年龄<65岁的患者中，已婚或与他人同住对男性MCS的益处大于女性。
女性退伍军人VA患者与男性退伍军人一样，承受着沉重的身心疾病负担，预计需要相当强度的医疗保健服务。她们健康状况不佳是在社会支持不足的背景下发生的，并且因年龄而异。
