Access to care for women Veterans

Background: Timely access to healthcare is essential to ensuring optimal health outcomes, and not surprisingly, is at the heart of healthcare reform efforts. While the Veterans Health Administration (VA) has made improved access a priority, women Veterans still underutilize VA healthcare relative to men. Eliminating access disparities requires a better understanding of the barriers to care that women Veterans' experience. Objective: We examined the association of general and Veteran-specific barriers on women Veterans' healthcare access. Design and Participants: Cross-sectional, population-based national telephone survey of 3,611 women Veterans. Main Measure: Delayed healthcare or unmet healthcare need in the prior 12 months. Key Results: 19% of women Veterans had delayed healthcare or unmet need, with higher rates in younger age groups. Among those delaying or going without care, barriers that varied by age group were: unaffordable healthcare (63% of 18-34 versus 12% of 65-plus age groups); inability to take off from work (39% of those <50); and transportation difficulties (36% of 65-plus). Controlling for demographic, health, and healthcare characteristics, being uninsured, knowledge gaps about VA care, perception that VA providers are not gender-sensitive, and military sexual assault history predicted delaying or foregoing care, whereas VA use and enrollment priority did not. Conclusions: Many of the identified access barriers are potentially modifiable through expanded VA healthcare and social services. Health reform efforts should address these barriers for VA nonusers. Efforts are also warranted to improve women Veterans' knowledge of availability and affordability of VA healthcare, and to enhance the gender-sensitivity of this care.