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Effect of Health-Related Quality of Life on Women and Men’s Veterans Affairs (VA) Health Care Utilization and Mortality

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Abstract

Introduction

Although women will account for almost 11% of veterans by 2040, we know little about their health and functioning, particularly compared to men.

Objective

To compare women and men veterans’ health-related quality of life (HRQOL) and VA health care utilization and to see if previously described associations between HRQOL, subsequent VA health care utilization, and mortality in male veterans would generalize to women veterans.

Methods

Prospective cohort study of all veterans who received medical care from an Upper Midwest Veterans Affairs facility between 10/1/96 and 3/31/98 and returned a mailed questionnaire.

Results

Women’s effective survey response rate was 52% (n = 1,500); men’s, 58% (n = 35,000). In the following year, 9% of women and 12% of men had at least one hospitalization. One percent of women and 3% of men died in the post-survey year. After adjustment, women’s HRQOL was higher than men’s; for every 10-point decrement in overall physical or mental functioning, women and men had similarly increased risk/odds of subsequently dying, being hospitalized at a VA facility, or making a VA outpatient stop. Among younger women and women who received VA care outside of the Twin City metro area, poorer overall mental or physical health functioning was associated with fewer primary care stops; among their male counterparts, it was associated with more primary care stops.

Conclusion

Compared to men, women veterans receiving VA health care in the upper Midwest catchment area had better HRQOL and used fewer health services. Although VA health care utilization was similar across gender after adjusting for HRQOL, poorer mental or physical health was associated with fewer primary care stops for selected subgroups of women.

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Acknowledgement

We thank Alisha Baines from the Center for Chronic Disease Outcomes Center of the Minneapolis VA Medical Center, Minneapolis, MN for her help with making graphs. We thank Kristin Nichol, MD, MPH, MBA and Angeliki Georgopoulos, MD for their helpful comments on earlier manuscript drafts. We thank David Nelson, PhD, for statistical assistance.

Grant Support: VA Upper Midwest Veterans Integrated Service Network (VISN-13). Supported by the NIH CTSA Award 1 KL2 RR024151-01 (Mayo Clinic Center for Clinical and Translational Research). Dr. Murdoch is a core investigator at the Center for Chronic Diseases Outcomes (CCDOR), a VA Health Services Research and Development Services Center of Excellence. Dr. Singh is a VA Clinical Scholar at the Center for Epidemiological and Clinical Research (CECR) at the Minneapolis VA Medical Center.

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

Conflict of interest

None disclosed.

Author information

Authors and Affiliations

  1. Rheumatology Section, Minneapolis VA Medical Center, Minneapolis, MN, USA

    Jasvinder A. Singh MD, MPH

  2. Medicine Service, Minneapolis VA Medical Center, Minneapolis, MN, USA

    Jasvinder A. Singh MD, MPH & Maureen Murdoch MD, MPH

  3. Division of Rheumatology, University of Minnesota, Minneapolis, MN, USA

    Jasvinder A. Singh MD, MPH

  4. Department of Medicine, University of Minnesota, Minneapolis, MN, USA

    Jasvinder A. Singh MD, MPH & Maureen Murdoch MD, MPH

  5. Center for Epidemiological and Clinical Research (CECR), VA Medical Center, Minneapolis, MN, USA

    Jasvinder A. Singh MD, MPH

  6. Center for Chronic Disease Outcomes Research (CCDOR), VA Medical Center, Minneapolis, MN, USA

    Jasvinder A. Singh MD, MPH & Maureen Murdoch MD, MPH

  7. Rheumatology Division (111 R), Minneapolis VA Medical Center, One Veteran’s Drive, Minneapolis, MN, 55417, USA

    Jasvinder A. Singh MD, MPH

  8. Visiting Scientist, Mayo Clinic School of Medicine, Rochester, MN, USA

    Jasvinder A. Singh MD, MPH

Authors
  1. Jasvinder A. Singh MD, MPH
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  2. Maureen Murdoch MD, MPH
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Corresponding author

Correspondence to Jasvinder A. Singh MD, MPH.

Additional information

CCDOR is a VA Health Services and Research service Center of Excellence.

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Singh, J., Murdoch, M. Effect of Health-Related Quality of Life on Women and Men’s Veterans Affairs (VA) Health Care Utilization and Mortality. J GEN INTERN MED 22, 1260–1267 (2007). https://doi.org/10.1007/s11606-007-0254-9

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  • DOI: https://doi.org/10.1007/s11606-007-0254-9

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