Center for Comprehensive Access & Delivery Research and Evaluation (CADRE), VA Office of Rural Health (ORH), University of Iowa College of Medicine, Iowa City, Iowa 52246, USA.
Womens Health Issues. 2011 Jul-Aug;21(4 Suppl):S120-9. doi: 10.1016/j.whi.2011.04.021.
Assessment of women veterans' health needs and preferences and their care environment have been identified as a priority research need by the national Veterans Affairs (VA) Women's Health research agenda. Our objective was to identify women veterans' health care preferences and perceptions associated with sole or dual VA health care use.
This cross-sectional study of 1,002 VA-enrolled Midwestern veterans was performed by computer-assisted telephone interviews.
Sole and dual (both VA and non-VA) users of VA care were more likely to have served in a combat area, have a current diagnosis of posttraumatic stress disorder, and poorer physical health scores than non-VA users. Non-VA users were more likely to be married and have private health insurance. Sole VA users were more likely to want a choice of a male or female health care provider. Both sole and dual VA users believed that the VA provides adequate privacy and safety during outpatient examinations compared with non-users. Urban women veterans were more likely to endorse specific environment of care preferences such as gender-specific waiting areas compared with rural veterans.
Care preferences were similar regardless of VA use; however, perceptions of VA care varied. Women using VA care solely had the most positive perceptions of VA care, followed by dual users then non-VA users. Rural women were similar to urban veterans, but were less likely to endorse specific care preferences. Considering these differences with regard to need and access can inform VA policy and initiatives on improving access to and use of VA care among women veterans in urban and rural areas.
评估女性退伍军人的健康需求和偏好及其护理环境已被确定为国家退伍军人事务部(VA)妇女健康研究议程的优先研究需求。我们的目的是确定女性退伍军人对医疗保健的偏好和看法,这些偏好和看法与单独或双重使用 VA 医疗保健有关。
这项对中西部 1002 名 VA 登记退伍军人的横断面研究是通过计算机辅助电话访谈进行的。
与非 VA 用户相比,仅使用 VA 护理和同时使用 VA 和非 VA 护理的退伍军人更有可能在战区服役、目前被诊断患有创伤后应激障碍和身体健康评分较差。非 VA 用户更有可能已婚并拥有私人医疗保险。仅使用 VA 的退伍军人更有可能希望选择男性或女性医疗保健提供者。仅使用 VA 和同时使用 VA 的退伍军人都认为 VA 在门诊检查期间提供足够的隐私和安全保障,而非用户则认为 VA 提供的隐私和安全保障不足。与农村退伍军人相比,城市女性退伍军人更有可能支持特定的护理环境偏好,例如性别特定的等候区。
无论是否使用 VA,护理偏好都相似;然而,对 VA 护理的看法有所不同。仅使用 VA 护理的退伍军人对 VA 护理的看法最为积极,其次是双重使用者,然后是非 VA 用户。农村女性与城市退伍军人相似,但不太可能支持特定的护理偏好。考虑到这些与需求和获得有关的差异,可以为 VA 制定政策和举措提供信息,以改善城市和农村地区女性退伍军人获得和使用 VA 护理的机会。