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新的退伍军人医疗保健系统中的女性退伍军人:纵向分析。

New women veterans in the VHA: a longitudinal profile.

机构信息

Center for Health Care Evaluation, VA Palo Alto Health Care System, Palo Alto, California 94025, USA.

出版信息

Womens Health Issues. 2011 Jul-Aug;21(4 Suppl):S103-11. doi: 10.1016/j.whi.2011.04.025.

Abstract

OBJECTIVE

The number of women veterans using Veterans Health Administration (VHA) services has increased rapidly, but the characteristics of women joining VHA are not well understood. We sought to describe sociodemographic characteristics, utilization, and retention of new and returning women VHA patients over a 7-year period.

METHODS

We identified women veterans who used VHA outpatient services from VHA Enrollment and Utilization files for fiscal years 2003 through 2009. "New" patients in a given year had no outpatient use within the prior 3 years. Patients were "retained" if they continued to use VHA in subsequent years.

MAIN FINDINGS

Of the 287,447 women veteran VHA outpatients in 2009, 40,000 (14%) were new to VHA in that year and over half had joined VHA since 2003. Nearly two thirds of these new patients were younger than 45, and 43% carried a service-connected disability status. Most new patients (88%) received primary care services in 2008, and 40% used mental health services. Repeated use of mental health services (at least three visits per year) nearly doubled among new patients (from 11% in 2003 to 20% in 2008). Among those using VHA primary care in 2006, 68% of new patients versus 91% of returning patients were retained in either of the subsequent 2 years.

CONCLUSION

The influx of new women veterans seeking VHA services in recent years, combined with their high rate of retention within VHA, contribute to the marked increase in numbers of women veterans using VHA. Many require fairly intensive VHA services.

摘要

目的

使用退伍军人健康管理局(VHA)服务的女性退伍军人人数迅速增加,但加入 VHA 的女性特征尚未得到很好的理解。我们旨在描述在过去 7 年中,新加入和重新加入 VHA 的女性患者的社会人口统计学特征、利用情况和保留率。

方法

我们从 2003 年至 2009 年的 VHA 登记和利用档案中确定了使用 VHA 门诊服务的女性退伍军人。在给定年份中,“新”患者在过去 3 年内没有门诊就诊记录。如果患者在随后的年份继续使用 VHA,则被视为“保留”。

主要发现

在 2009 年的 287447 名女性退伍军人 VHA 门诊患者中,有 40000 人(14%)是当年新加入 VHA 的,超过一半的人是自 2003 年以来加入 VHA 的。这些新患者中近三分之二年龄小于 45 岁,43%携带与服务相关的残疾状况。大多数新患者(88%)在 2008 年接受了初级保健服务,40%使用了心理健康服务。新患者中使用心理健康服务的频率(每年至少 3 次就诊)几乎翻了一番(从 2003 年的 11%增加到 2008 年的 20%)。在 2006 年使用 VHA 初级保健的患者中,新患者中有 68%,而在重新加入 VHA 的患者中有 91%,在随后的 2 年内保留了 VHA。

结论

近年来,新的女性退伍军人寻求 VHA 服务的涌入,加上她们在 VHA 内的高保留率,导致使用 VHA 的女性退伍军人数量显著增加。许多人需要相当密集的 VHA 服务。

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