West Alan N, Lee Pamela W
Research Service, VAMC (10A5A), 215 N. Main Street, White River Junction, VT 05009.
Mil Med. 2013 Nov;178(11):1250-5. doi: 10.7205/MILMED-D-13-00200.
Women Veterans enrolled in Veterans Affairs (VA) health care almost always use non-VA hospitals for childbirth, making it more likely they will use non-VA hospitals for other needs, as well. We compared VA and non-VA hospitalizations obtained by VA enrollees in seven states from 2004 through 2007 to determine whether women aged 18 to 44 were more likely to use VA or non-VA care for diagnoses in certain major categories, and how this use differed between women who did or did not have any pregnancy/childbirth admissions during the 4 years. We found that women were hospitalized much more in non-VA than in VA hospitals, though they were relatively more likely to use VA hospitals for mental illness, digestive system diseases, and neoplasms than other diagnoses. Women who gave birth during the time interval had very few VA admissions for any diagnosis, and compared to other women they were also less likely to be hospitalized for mental health or cancer, but more likely to be hospitalized for infectious and parasitic diseases. VA hospitals were used more by women who were slightly older, sicker, poorer, and living nearer to them. VA-using women tend to have different and greater medical needs than those having children.
参加退伍军人事务部(VA)医疗保健项目的女性退伍军人分娩时几乎总是选择非VA医院,这也使得她们更有可能因其他需求而使用非VA医院。我们比较了2004年至2007年期间七个州的VA参保人在VA医院和非VA医院的住院情况,以确定18至44岁的女性在某些主要类别诊断中使用VA医疗还是非VA医疗的可能性更大,以及在这4年中有或没有任何妊娠/分娩住院记录的女性之间这种使用情况有何不同。我们发现,女性在非VA医院的住院次数远多于VA医院,不过与其他诊断相比,她们因精神疾病、消化系统疾病和肿瘤使用VA医院的可能性相对更大。在此时间段内分娩的女性因任何诊断入住VA医院的次数都很少,与其他女性相比,她们因心理健康问题或癌症住院的可能性也较小,但因传染病和寄生虫病住院的可能性更大。年龄稍大、病情较重、较贫困且住得离VA医院较近的女性更多地使用VA医院。使用VA医院的女性往往比有孩子的女性有不同且更多的医疗需求。