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Article APA Reference

Sheahan, K. L., Goldstein, K. M., Than, C. T., Bean-Mayberry, B., Chanfreau, C. C., Gerber, M. R., Rose, D. E., Brunner, J., Canelo, I. A., Darling MSHS, J. E., Haskell, S., Hamilton, A. B., & Yano, E. M. (2022). Women Veterans’ Healthcare Needs, Utilization, and Preferences in Veterans Affairs Primary Care Settings. Journal of General Internal Medicine, 37(S3), 791–798. https://doi.org/10.1007/s11606-022-07585-3

Justification/Rationale for Study

The study sought to address the lack of understanding regarding the healthcare requirements, utilization, and preferences of female Veterans who regularly use VA primary care, in order to inform evidence-based care delivery changes. Given the growing number of female Veterans using VA services and the particular barriers they may experience in receiving complete treatment, recognizing their healthcare requirements and preferences is critical for designing specialized and successful healthcare services.

Gap in Practice

Despite major advances in VA women's healthcare, little was known about the characteristics, utilization patterns, and preferences of female Veterans who consistently seek VA primary care. This study aims to fill a knowledge gap by giving insights about women Veterans' healthcare needs and preferences, which might be used to improve care delivery and resource allocation within the VA system.

Purpose of the Study

(Include list of independent variables [IVs] and dependent variables [DVs])

The study's goal was to describe the healthcare requirements, utilization patterns, and preferences of female veterans who regularly use VA primary care. The independent variables (IVs) included sociodemographic parameters, health status (including chronic diseases, mental health, pain, and trauma exposure), healthcare utilization, treatment choices, and satisfaction. The dependent variables (DVs) covered a wide range of healthcare requirements, utilization, and preferences among women Veterans.

Theoretical or Conceptual Framework

The study made no particular reference to a specific theoretical or conceptual framework. However, it is likely that it used frameworks linked to patient-centered care, women's health, and trauma-informed care to guide the assessment of healthcare needs, utilization patterns, and preferences among female veterans.

Study Design and Sampling Procedures

The study used a cross-sectional survey methodology and included 1,391 female Veterans who had three or more primary care visits in the previous year at 12 VA medical institutions across nine states. Sampling procedures included choosing participants from VA institutions with various treatment models for female veterans while assuring representation across geographical regions, resource levels, and sizes.

Data Collection Procedures

Between January and March 2015, data was collected through a telephone survey using computer-assisted telephone interviewing (CATI). The survey collected data on sociodemographic variables, health status, healthcare use, care choices, and satisfaction. Additionally, specific utilization metrics were collected from VA administrative data.

Data Analyses Used

Descriptive analyses were performed on the entire sample and by age group. Analyses were weighted to reflect the population of women who routinely use VA primary care and controlled for sample design and potential non-response bias. The data were analyzed with Stata Version 15.

Description of Significant Results

The study discovered that women Veterans who regularly use VA primary care have severe multimorbid physical and mental health disorders, such as chronic diseases, mental health concerns, and trauma histories. Healthcare utilization was primarily inside the VA system, with high rates for mental health and specialty care. Women veterans reported a preference for female clinicians and women-only care settings, highlighting the need of gender-specific care. Overall satisfaction with VA women's healthcare was excellent, however views of care quality differed by age group.

Discussion of Findings, including Limitations of the Study

The study examined the significance of its findings for enhancing treatment delivery for female veterans in the VA system. It emphasized the importance of continuing to invest in woman-centered primary care, integrated mental health care, and trauma-informed care to meet the complex healthcare requirements of female veterans throughout their lives. Limitations included potential self-report biases and a focus on women who frequently use VA primary care, which may not represent all female Veterans.