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BACKGROUND AND OBJECTIVE: Effects of advances in Department of Veterans Affairs (VA) women’s health care on women veterans’ health care decision making are unknown. Our objective was to determine why women veterans use or do not use VA health care.
DESIGN AND PARTICIPANTS: Cross-sectional survey of 2,174 women veteran VA users and VA-eligible nonusers throughout southern California and southern Nevada.
MEASUREMENTS: VA utilization, attitudes toward care, and socio-demographics.
RESULTS: Reasons cited for VA use included affordability (67.9%); women’s health clinic (WHC) availability (58.8%); quality of care (54.8%); and convenience (47.9%). Reasons for choosing health care in non-VA settings included having insurance (71.0%); greater convenience of non-VA care (66.9%); lack of knowledge of VA eligibility and services (48.5%); and perceived better non-VA quality (34.5%). After adjustment for sociodemographics, health characteristics, and VA priority group, knowledge deficits about VA eligibility and services and perceived worse VA care quality predicted outside health care use. VA users were less likely than non-VA users to have after-hours access to nonemergency care, but more likely to receive both general and gender-related care from the same clinic or provider, to use a WHC for gender-related care, and to consider WHC availability very important.
CONCLUSIONS: Lack of information about VA, perceptions of VA quality, and inconvenience of VA care, are deterrents to VA use for many women veterans. VA WHCs may foster VA use. Educational campaigns are needed to fill the knowledge gap regarding women veterans’ VA eligibility and advances in VA quality of care, while VA managers consider solutions to after-hours access barriers.
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- To use or not to use
Journal of General Internal Medicine
Volume 21, Issue 3 Supplement, pp S11-S18
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- women’s health services
- ambulatory care/utilization
- hospitals, veterans/utilization
- health services accessibility
- decision making
- choice behavior
- Industry Sectors
- Author Affiliations
- 1. VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., 111G, 90073, Los Angeles, CA
- 2. Department of Medicine, University of California Los Angeles (UCLA) School of Medicine, Los Angeles, CA, USA
- 3. VA Greater Los Angeles Health Services Research and Development (HSR&D) Center of Excellence, VA Sepulveda Ambulatory Care Center and Nursing Home, Sepulveda, CA, USA
- 4. Department of Health Services, UCLA School of Public Health, Los Angeles, CA, USA