VA Puget Sound Health Care System, Seattle, Washington, and University of Washington, USA.
Psychol Serv. 2013 May;10(2):203-12. doi: 10.1037/a0031596.
As the number of women veterans continues to rise, an issue of concern is whether those with mental health symptoms experience disproportionate barriers to care. The purpose of this study was to examine unmet medical needs and barriers to health care among women veterans who screened positive for lifetime posttraumatic stress disorder (PTSD), current depressive symptoms, both or neither. Using the National Survey of Women Veterans dataset (N = 3,593), we compared women veterans corresponding to these 4 groups on whether they had unmet medical needs in the past year, reasons for unmet needs, and barriers to using VA care for those not currently doing so. The majority of women veterans who screened positive for both PTSD and depressive symptoms had unmet medical care needs in the prior 12 months (59%), compared to 30% of women with PTSD symptoms only, 18% of those with depressive symptoms only, and 16% of women with neither set of symptoms. Among those reporting unmet medical needs (n = 840), those with both PTSD and depressive symptoms were more likely than the other groups to identify affordability as a reason for going without or delaying care. Among women veterans not using VA health care (n = 1,677), women with both PTSD and depressive symptoms were more likely to report not knowing if they were eligible for VA benefits and were less likely to have health insurance to cover care outside of the VA. These data highlight specific areas of vulnerability of women veterans with comorbid PTSD and depressive symptoms and identify areas of concern as VA and other health facilities work to ensure equitable access to care.
随着女性退伍军人人数的不断增加，一个令人关注的问题是，那些有心理健康症状的人是否会面临不成比例的护理障碍。本研究的目的是检查在筛查出患有创伤后应激障碍（PTSD）、当前抑郁症状、两者或两者都没有的女性退伍军人中，未满足的医疗需求和医疗保健障碍。使用全国女性退伍军人调查数据集（N=3593），我们将对应于这 4 组的女性退伍军人进行比较，比较他们在过去一年中是否有未满足的医疗需求、未满足需求的原因以及对于那些目前未使用 VA 护理的人来说使用 VA 护理的障碍。与只有 PTSD 症状的女性（30%）、只有抑郁症状的女性（18%）或没有任何一组症状的女性（16%）相比，筛查出 PTSD 和抑郁症状两者的女性退伍军人中，有 59%的人在过去 12 个月中有未满足的医疗护理需求。在报告未满足医疗需求的女性（n=840）中，有 PTSD 和抑郁症状两者的女性比其他群体更有可能将负担能力作为不接受或延迟护理的原因。在不使用 VA 医疗保健的女性退伍军人中（n=1677），有 PTSD 和抑郁症状两者的女性更有可能报告不知道自己是否有资格获得 VA 福利，并且更有可能没有医疗保险来支付 VA 以外的医疗费用。这些数据突出了患有共病 PTSD 和抑郁症状的女性退伍军人的特定脆弱领域，并确定了 VA 和其他医疗机构在努力确保公平获得护理方面的关注领域。
