Association between Women Veterans' Experiences with VA Outpatient Health Care and Designation as a Women's Health Provider in Primary Care Clinics |
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| Authors: | Lori A. Bastian Mark Trentalange Terrence E. Murphy Cynthia Brandt Bevanne Bean-Mayberry Natalya C. Maisel Steven M. Wright Vera S. Gaetano Heather Allore Melissa Skanderson Evelyn Reyes-Harvey Elizabeth M. Yano Danielle Rose Sally Haskell |
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| Affiliation: | 1. VA Connecticut Healthcare System, West Haven, Connecticut;2. University of Connecticut Health Center, Farmington, Connecticut;3. VA Connecticut Healthcare System, West Haven, Connecticut;4. Veterans Health Administration Health Services Research & Development Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Sepulveda, California;5. Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California;6. Office of Performance Measurement, Department of Veterans Affairs, Providence, Rhode Island;7. Department of Veterans Affairs, Pittsburgh, Pennsylvania;8. Office of Performance Measurement, Office of Analytics & Business Intelligence, Durham, North Carolina;9. Department of Health Policy & Management, UCLA Fielding School of Public Health, Los Angeles, California;10. Women''s Health Services, Patient Care Services, VA Central Office, VA Connecticut Healthcare System Yale School of Medicine, West Haven, Connecticut |
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| Abstract: | BackgroundWomen veterans comprise a small percentage of Department of Veterans Affairs (VA) health care users. Prior research on women veterans' experiences with primary care has focused on VA site differences and not individual provider characteristics. In 2010, the VA established policy requiring the provision of comprehensive women's health care by designated women's health providers (DWHPs). Little is known about the quality of health care delivered by DWHPs and women veterans' experience with care from these providers.MethodsSecondary data were obtained from the VA Survey of Healthcare Experience of Patients (SHEP) using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient-centered medical home (PCMH) survey from March 2012 through February 2013, a survey designed to measure patient experience with care and the DWHPs Assessment of Workforce Capacity that discerns between DWHPs versus non-DWHPs.FindingsOf the 28,994 surveys mailed to women veterans, 24,789 were seen by primary care providers and 8,151 women responded to the survey (response rate, 32%). A total of 3,147 providers were evaluated by the SHEP-CAHPS-PCMH survey (40%; n = 1,267 were DWHPs). In a multivariable model, patients seen by DWHPs (relative risk, 1.02; 95% CI, 1.01–1.04) reported higher overall experiences with care compared with patients seen by non-DWHPs.ConclusionsThe main finding is that women veterans' overall experiences with outpatient health care are slightly better for those receiving care from DWHPs compared with those receiving care from non-DWHPs. Our findings have important policy implications for how to continue to improve women veterans' experiences. Our work provides support to increase access to DWHPs at VA primary care clinics. |
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