Issue 48 | Eating Disorders in Military and Defence Personnel
Military and civilian service professions, such as the Australian Defence Force (ADF) and emergency services, as well as elite sports professions, require a certain level of physical fitness, discipline and performance. The intensive training undertaken by those in high performance occupations may not always prepare them for the potential psychological impacts (VVCS, 2016; Bartlett & Mitchell, 2015).
In this e-Bulletin issue, the National Eating Disorders Collaboration (NEDC) gives an overview of the research on eating disorders in ex-serving military personnel, and takes a closer look at appropriate self-care and support pathways for Veterans, Australian Defence personnel and other elite professionals. This issue also discusses the risks and warning signs associated with eating disorders, to better assist health care providers, coaches and others working alongside people currently or previously involved in high performance occupations to appropriately identify and respond to symptoms.
Abstract: Background: Enactment of the Veterans Choice Act (VCA) in 2014 and expansion of Medicaid programs led to greater options for Veterans to receive health care outside of the U.S. Department of Veterans Affairs (VA). However, little is known about how much care women Veterans receive in VA or non-VA settings paid by VA or other insurance types. We explore trends in inpatient care received by women Veterans before and after implementation of the VCA, focusing on hospitalizations, as these patients are often higher risk. Methods: Data for women Veterans were linked to hospital discharge data for 2013-2017 from 11 diverse states. Patient and hospital characteristics by VA and non-VA payer and age group (less than 65 years and 65 years and older) were compared for acute hospitalizations in Pearson's chi-square and analysis of variance tests. We compared the odds of a hospitalization occurring before and after VCA implementation for each specific setting/payer using separate logistic regressions. Results: Our sample included 117,177 acute medical/surgical hospitalizations. For younger women, the most common hospital setting/payer was VA hospitals (36%); older women most frequently received hospital care in non-VA hospitals covered by Medicare (61%). After the VCA, the probability of receiving VA-purchased care increased significantly for older women only. Younger women saw a significant decrease in VA hospitalizations post-VCA. Conclusions: We found that after multiple expansions in non-VA health care options, women Veterans sought more VA-purchased community hospital care.