Improving access to service charities for female veterans
To date, considerations of improving access to and quality of care for veterans often emphasise male perspectives. This may not reflect the needs of female veterans, nor anticipate the needs of the increasing numbers of female service personnel as they leave service. In the work reported here we aimed to investigate public and charitable sector (service and nonservice) perspectives on the challenges and enablers female veterans face in accessing service charities, to inform and prioritise recommendations for tangible improvements in access to veteran specific services for female veterans. We achieved this aim by conducting a literature review, followed by a qualitative research study. This qualitative study comprised profiling the evolution of conditions for military service for females in UK Armed Forces, 38 stakeholder interviews, and website analysis. Findings and recommendations were discussed with an expert panel and the Project Advisory Group, and disseminated to a range of stakeholders over the course of the project. This report presents the findings of this research, discusses them in the context of previous work, and makes recommendations for service provision, policy and research.
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.