‘You’re in Your Own Time Now’: Understanding Current Experiences of Transition to Civilian Life in Scotland
Abstract: An informal mentor system, recognistion of qualifications from non-UK nationals and further support for the families of serving personnel are among several recommendations made by a new report looking at the transition of veterans and their families to civilian life in Scotland. The report provides a detailed account of the Armed Forces milieu in Scotland set against developments and future plans for the expansion of several bases across the country. This set the scene for the study and allowed for an improved understanding of the implications and the outcomes of the study and how findings may be applied.
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.