Living in our Shoes: Understanding the Needs of UK Armed Forces Families
Summary: This review was commissioned by the Ministry of Defence to explore the needs and concerns raised by Armed Forces families, as well as make recommendations for change. The responses to the Call for Evidence were extremely detailed and thoughtful, and concerns about various issues were tempered with positive comments about the exciting experiences and considerable opportunities that military life offers to members of the Armed Forces community. During the analysis of written submissions, face-to-face discussions, and our own observations at military bases, a number of key themes emerged about the challenges experienced by military families today. Across all three Services, the key issues raised were: accommodation, mobility, deployment and the amount of time, Serving personnel spend apart from their families, the impact of Service life on children and young people, the employment and careers of spouses/partners, the health and well-being of Serving personnel and family members and the impact of military life on personal relationships.
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.