Abstract
BackgroundThe number of women serving in the United States military increased during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), leading to a subsequent surge in new women Veterans seeking health care services from the Veterans Administration (VA). The objective of this study was to examine gender differences among OEF/OIF Veterans in utilization of VA outpatient health care services.MethodsOur retrospective cohort consisted of 1,620 OEF/OIF Veterans (240 women and 1380 men) who enrolled for outpatient healthcare at a single VA facility. We collected demographic data and information on military service and VA utilization from VA electronic medical records. To assess gender differences we used two models: use versus nonuse of services (logistic regression) and intensity of use among users (negative binomial regression).ResultsIn our sample, women were more likely to be younger, single, and non-white than men. Women were more likely to utilize outpatient care services (odds ratio [OR] = 1.47, 95% confidence interval [CI]:1.09, 1.98), but once care was initiated, frequency of visits over time (intensity) did not differ by gender (incident rate ratio [IRR] = 1.07; 95% CI: 0.90, 1.27).ConclusionRecently discharged OEF/OIF women Veterans were more likely to seek VA health care than men Veterans. But the intensity of use was similar between women and men VA care users. As more women use VA health care, prospective studies exploring gender differences in types of services utilized, health outcomes, and factors associated with satisfaction will be required.
Highlights
The number of women serving in the United States military increased during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), leading to a subsequent surge in new women Veterans seeking health care services from the Veterans Administration (VA)
Sample Our initial sample consisted of 1820 OEF/OIF Veterans who enrolled for care at the local Veterans Affairs Medical Center (VAMC) or at one of the six associated community-based outpatient clinics (CBOCS) between September 1, 2002, and October 30, 2006
54% (874/1620) of the study population did not have any visits to the local VAMC for outpatient health care
Summary
The number of women serving in the United States military increased during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), leading to a subsequent surge in new women Veterans seeking health care services from the Veterans Administration (VA). Men aged more than ≥ 59 years have higher health care utilization than women of the same age, younger women report higher use of health care services than men during their child bearing years [5,6]. These differences may be associated with reproductive biology, gender-specific conditions and higher morbidity rates in women in this age group [5,7,8,9,10]. Understanding the effect of gender and other underlying determinants on use of health care services is important in promoting equal access to health care
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