Gender and use of care: Planning for tomorrow's veterans health administration

被引:45
作者
Frayne, Susan M.
Yu, Wei
Yano, Elizabeth M.
Ananth, Lakshmi
Iqbal, Samina
Thrailkill, Ann
Phibbs, Ciaran S.
机构
[1] VA Palo Alto Hlth Care Syst, Ctr Hlth Care Evaluat, Menlo Pk, CA 94025 USA
[2] Stanford Univ, Sch Med, Div Gen Internal Med, Palo Alto, CA 94304 USA
[3] Stanford Univ, Sch Med, Ctr Hlth Policy, Palo Alto, CA 94304 USA
[4] Stanford Univ, Sch Med, Ctr Primary Care & Outcomes Res, Palo Alto, CA 94304 USA
[5] VA Palo Alto Hlth Care Syst, Womens Hlth Ctr, Palo Alto, CA USA
[6] VA Palo Alto Hlth Care Syst, Hlth Econ Resource Ctr, Menlo Pk, CA 94025 USA
[7] VA Greator Los Angeles HSR&D Ctr Study Heathcare, Sepulveda, CA USA
[8] Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA
[9] Stanford Univ, Sch Med, Dept Hlth Res & Policy, Palo Alto, CA 94304 USA
[10] Stanford Univ, Sch Med, Dept Pediat, Palo Alto, CA 94304 USA
关键词
D O I
10.1089/jwh.2006.0205
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Historically, men have been the predominant users of Veterans Health Administration (VHA) care. With more women entering the system, a systematic assessment of their healthcare use and costs of care is needed. We examined how utilization and costs of VHA care differ in women veterans compared with men veterans. Methods: In this cross-sectional study using centralized VHA administrative databases, main analyses examined annual outpatient and inpatient utilization and costs of care (outpatient, inpatient, and pharmacy) for all female (n = 178,849) and male (n = 3,943,532) veterans using VHA in 2002, accounting for age and medical/mental health conditions. Results: Women had 11.8% more outpatient encounters, 25.9% fewer inpatient days, and 11.4% lower total cost than men; after adjusting for age and medical comorbidity, differences were less pronounced (1.3%, 10.9%, and 2.8%, respectively). Among the 30.8% of women and 24.4% of men with both medical and mental health conditions, women used outpatient services more heavily than men (31.0 vs. 27.3 annual encounters). Conclusions: VHA's efforts to build capacity for women veterans must account for their relatively high utilization of outpatient services, which is especially prominent in women who have both medical and mental health conditions. Meeting their needs may require delivery systems integrating medical and mental healthcare.
引用
收藏
页码:1188 / 1199
页数:12
相关论文
共 48 条
  • [1] [Anonymous], 2004, CLIN CLASS SOFTW CCS
  • [2] Geographic variations in utilization rates in Veterans Affairs hospitals and clinics
    Ashton, CM
    Petersen, MPHNJ
    Souchek, J
    Menke, TJ
    Yu, HJ
    Pietz, K
    Eigenbrodt, ML
    Barbour, G
    Kizer, KW
    Wray, NP
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1999, 340 (01) : 32 - 39
  • [3] BAINE D, 1994, VA HEALTHCARE WOMEN
  • [4] Women in the Gulf War: Combat experience, exposures, and subsequent health care use
    Carney, CP
    Sampson, TR
    Voelker, M
    Woolson, R
    Thorne, P
    Doebbeling, BN
    [J]. MILITARY MEDICINE, 2003, 168 (08) : 654 - 661
  • [5] *DEP VET AFF, ORI VA MOTT
  • [6] *DEP VET AFF, WHO WE SEERV FY2002
  • [7] The role of psychiatric diagnosis in satisfaction with primary care - Data from the department of veterans affairs
    Desai, RA
    Stefanovics, EA
    Rosenheck, RA
    [J]. MEDICAL CARE, 2005, 43 (12) : 1208 - 1216
  • [8] Desai Rani A., 2000, J Ment Health Policy Econ, V3, P61, DOI 10.1002/1099-176X(200006)3:2<61::AID-MHP74>3.0.CO
  • [9] 2-F
  • [10] The relationship between continuity of care and the health behaviors of patients - Does having a usual physician make a difference?
    Ettner, SL
    [J]. MEDICAL CARE, 1999, 37 (06) : 547 - 555