Where do women veterans get their inpatient care?
OBJECTIVE
In this study we explore women veterans' use of Veterans Administration (VA) and private sector inpatient services.


METHODS
Using a comprehensive dataset of VA and private hospital admissions, we identified 1,409 female patients who were enrolled in the VA system and had an inpatient admission between 1998 and 2000 in either the VA or the private sector. For Major Diagnostic Categories (MDCs) with >20 admits in each sector, we compared care provided in the private sector with care provided in the VA with respect to patient characteristics and resource utilization. In addition, we determined payment sources for women who used the private sector for inpatient care.


RESULTS
Women who used the VA were younger (mean, 54 vs. 60 years; p < .001) and more likely to be service connected (39% vs. 24%; p < .001), African American (25% vs. 13%; p < .001), and urban dwelling (81% vs. 75%; p < .01). Women veterans were significantly more reliant on the VA system for mental diseases, alcohol and drug use, and skin/subcutaneous/breast diseases. For every MDC examined, VA hospitals had longer mean lengths of stay. Among VA eligible women <65 years old using the private sector, 56% used private insurance, 15% used Medicare, 14% used Medicaid, and 9% did not have insurance.


CONCLUSIONS
In New York, female veterans admitted to VA hospitals differed from women admitted to private hospitals by patient characteristics, admission reason, and admission resource consumption. Many younger women who used the private sector were reliant on other government agencies (Medicaid or Medicare) or out-of-pocket payments for their inpatient care.
VA Quality Scholars Fellowship Program, White River Junction, Vermont, USA. Susan.E.Mooney@Hitchcock.org
Susan E
SE
Mooney
William B
WB
Weeks
D000368:Aged; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017149:Private Sector / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*; D016387:Women's Health