Characterization and Comparison of Physical and Mental Health Profiles and Department of Veterans Affairs Health Care Utilization Patterns among Operation Iraqi Freedom/Operation Enduring Freedom Women Veterans in Puerto Rico versus the United States |
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| Affiliation: | 4. College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan;1. HealthPartners Institute, 8170 33rd Ave. S., MS23301A, Minneapolis, MN 55425;2. Institute for Clinical Systems Improvement, 8009 34th Ave. S., Suite 1200, Bloomington, MN, 55425-1624;3. Kaiser Permanente Colorado Institute for Health Research, P.O. Box 378066, Denver, CO, 80237-8066;4. Kaiser Permanente Southern California, Department of Research and Evaluation, 100 S. Los Robles Ave., 2nd Floor, Pasadena, CA, 91101-2453;5. Mayo Clinic, Psychiatry and Psychology Division of Integrated Behavioral Health, 200 First St. SW, Rochester, MN, 55905;6. University of St. Thomas, School of Social Work, 2115 Summit Ave, St. Paul, MN, 55105;7. Community Health Plan of Washington, 720 Olive Way, Suite 300, Seattle, WA, 98101-1830;8. Mount Auburn Cambridge Independent Practice Association, 1380 Soldiers Field Rd., Floor 2, Brighton, MA, 02135-1023;9. Pittsburgh Regional Health Initiative, 650 Smithfield St., Centre City Tower, Suite 2400, Pittsburgh, PA, 15222-3900;10. Michigan Center for Clinical Systems Improvement, 233 E. Fulton St., Suite 20, Grand Rapids, MI, 49503-3261;11. University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA, 98195-6560 |
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| Abstract: | BackgroundResearch on the physical and mental health profiles and patterns of health care use among women veterans receiving health care from the Department of Veterans Affairs (VA) on the island of Puerto Rico is lacking.MethodsThis cross-sectional study examines differences in physical and mental health conditions, and patterns of VA health care use, between women veterans of the Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) era who were using VA facilities in Puerto Rico (n = 897) and those using U.S.-based VA facilities (n = 117,216) from 2002 to 2015.ResultsResults of fully adjusted logistic regression models revealed that OIF/OEF women in Puerto Rico had heightened risk for global pain-related disorders (i.e., any pain) (adjusted odds ratio [AOR], 1.45; 95% confidence interval [CI], 1.22–1.71), back pain (AOR, 1.83; 95% CI, 1.56–2.14), diabetes (AOR, 1.42; 95% CI, 1.03–1.95), hyperlipidemia (AOR, 3.34; 95% CI, 2.80–3.98), major depression (AOR, 1.78; 95% CI, 1.53–2.06), and bipolar depression (AOR, 1.66; 95% CI, 1.34–2.04). They also evidenced greater risk for a host of reproductive health conditions and had higher average annual use of VA health care than their U.S. counterparts.ConclusionsOIF/OEF women receiving VA health care in Puerto Rico evidenced a greater burden of physical illness, depression, and heightened use of VA health care services relative to their U.S. counterparts. Providers’ increased awareness of the physical and mental health care needs of this population is warranted. Research efforts that help to identify efficient and effective strategies to provide culturally tailored and/or personalized health care for this population could also be useful. |
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