Federally funded comprehensive women's health centers: leading innovation in women's healthcare delivery.
OBJECTIVE
Women's healthcare has historically been fragmented, given the artificial separation of reproductive care from general medical care. Aiming to advance new care models for delivery of comprehensive, integrated clinical care for women, two federal agencies-the U.S. Department of Health and Human Services (DHHS) and Department of Veterans Affairs (VA)-launched specialized women's health centers (WHCs). Exemplars of comprehensive service delivery, these originally federally funded centers have served as foundations for innovations in delivering comprehensive care to women in diverse practice settings. Little is known, however, about details of their organization, staffing, practice arrangements, and service availability that might inform adoption of similar models in the community.


METHODS
Using comparable key informant surveys, we collected organizational data from the DHHS National Centers of Excellence (CoE) (n = 13) and the original VA comprehensive WHC's (n = 8). We abstracted supplemental data (e.g., academic affiliation) from the 2001 American Hospital Association (AHA) survey.


RESULTS
All DHHS and VA women's health programs served urban areas, and nearly all had academic partnerships. DHHS centers had three times the average caseload as did VA centers. Preventive cancer screening and general reproductive services were uniformly available at all centers, although DHHS centers offered extensive reproductive services on-site more frequently, and VA centers more often had on-site mental healthcare.


CONCLUSIONS
The DHHS and VA comprehensive WHCs share similar missions and comparable organization, education, and clinical services, demonstrating their commitment to reducing fragmented service delivery. Their common structural components present opportunities for further advancing women's quality of care across other systems of care.
Bean-Mayberry
Bevanne
B
VA HSR&D Center of Excellence for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Health- care System, Sepulveda, California 91343, USA. Bevanne.bean-mayberry@va.gov
Yano
Elizabeth M
EM
Bayliss
Nichole
N
Navratil
Judith
J
Weisman
Carol S
CS
Scholle
Sarah Hudson
SH
D005260:Female; D005380:Financing, Government; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000706:statistics & numerical data; D006787:Hospitals, Veterans / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D017146:Models, Organizational; D009936:Organizational Innovation; D011320:Primary Health Care / Q000458:organization & administration; D011787:Quality of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans; D016387:Women's Health / Q000191:economics*; D014932:Women's Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data