Where Do Women Veterans Get Their Inpatient Care?

Mooney, Susan E.; Weeks, William B.

doi:10.1016/j.whi.2007.08.006

« Previous Next »Women's Health Issues
Volume 17, Issue 6 , Pages 367-373, November 2007

Where Do Women Veterans Get Their Inpatient Care?

Susan E. Mooney, MD, MS
- VA Quality Scholars Fellowship Program, White River Junction, Vermont
- Dartmouth Medical School, Hanover, New Hampshire
- Susan E. Mooney, MD, MS, recently completed the VA National Quality Scholars Fellowship at the White River Junction VA Hospital. As an Obstetrician/Gynecologist, her interests focused on improving the quality of healthcare for female veterans. After completing the fellowship, Dr. Mooney returned to the private sector where she now practices Gynecology and serves as the Medical Director for Quality Improvement at a hospital in Lebanon, NH.
- Correspondence to: Sue Mooney, MD, MS, Women’s Care Center at Alice Peck Day Memorial Hospital, 141 Mascoma Street, Lebanon, NH 03766. Phone: 603-448-3996; fax: 603-448-6863.
William B. Weeks, MD, MBA
- VA Quality Scholars Fellowship Program, White River Junction, Vermont
- National Center for Patient Safety
- VA Outcomes Group REAP, VAMC, White River Junction, Vermont
- Departments of Psychiatry and of Community and Family Medicine, Dartmouth Medical School, Hanover, New Hampshire
- William B. Weeks, MD, MBA, is affiliated with the Veterans Affairs Outcomes Group REAP, Veterans Affairs Hospital, White River Junction, Vermont and the Center for Evaluative Clinical Sciences, Dartmouth Medical School. He is also the Director of the White River Junction, Vermont field office of VHA’s National Center for Patient Safety. His research interests include health economics, patient safety, rural veterans’ health care.

Received 9 January 2007; accepted 30 August 2007.

Purpose

In this study we explore women veterans’ use of Veterans Administration (VA) and private sector inpatient services.

Methods

Using a comprehensive dataset of VA and private hospital admissions, we identified 1,409 female patients who were enrolled in the VA system and had an inpatient admission between 1998 and 2000 in either the VA or the private sector. For Major Diagnostic Categories (MDCs) with >20 admits in each sector, we compared care provided in the private sector with care provided in the VA with respect to patient characteristics and resource utilization. In addition, we determined payment sources for women who used the private sector for inpatient care.

Findings

Women who used the VA were younger (mean, 54 vs. 60 years; p < .001) and more likely to be service connected (39% vs. 24%; p < .001), African American (25% vs. 13%; p < .001), and urban dwelling (81% vs. 75%; p < .01). Women veterans were significantly more reliant on the VA system for mental diseases, alcohol and drug use, and skin/subcutaneous/breast diseases. For every MDC examined, VA hospitals had longer mean lengths of stay. Among VA eligible women <65 years old using the private sector, 56% used private insurance, 15% used Medicare, 14% used Medicaid, and 9% did not have insurance.

Conclusions

In New York, female veterans admitted to VA hospitals differed from women admitted to private hospitals by patient characteristics, admission reason, and admission resource consumption. Many younger women who used the private sector were reliant on other government agencies (Medicaid or Medicare) or out-of-pocket payments for their inpatient care.

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The views expressed in this article do not necessarily represent the views of the Department of Veterans Affairs or of the United States government.Supported by VA Health Services Research and Development Grants ACC 01-117-1, IIR 04–236, and REA 03-098.

PII: S1049-3867(07)00144-2

doi:10.1016/j.whi.2007.08.006

« Previous Next »Women's Health Issues
Volume 17, Issue 6 , Pages 367-373, November 2007

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