Five-year trends in women veterans' use of VA maternity benefits, 2008-2012.
BACKGROUND
An increasing number of young women veterans are returning from war and military service and are seeking reproductive health care from the Veterans Health Administration (VHA). Many of these women seek maternity benefits from the VHA, and yet little is known regarding the number of women veterans utilizing VHA maternity benefits nor the characteristics of pregnant veterans using these benefits. In May 2010, VHA maternity benefits were expanded to include 7 days of infant care, which may serve to entice more women to use VHA maternity benefits. Understanding the changing trends in women veterans seeking maternity benefits will help the VHA to improve the quality of reproductive care over time.


OBJECTIVE
The goal of this study was to examine the trends in delivery claims among women veterans receiving VHA maternity benefits over a 5-year period and the characteristics of pregnant veterans utilizing VHA benefits.


METHODS
We undertook a retrospective, national cohort study of pregnant veterans enrolled in VHA care with inpatient deliveries between fiscal years (FY) 2008 and 2012.


METHODS
We included pregnant veterans using VHA maternity benefits for delivery.


METHODS
Measures included annualized numbers and rates of inpatient deliveries and delivery-related costs, as well as cesarean section rates as a quality indicator.


RESULTS
During the 5-year study period, there was a significant increase in the number of deliveries to women veterans using VHA maternity benefits. The overall delivery rate increased by 44% over the study period from 12.4 to 17.8 deliveries per 1,000 women veterans. A majority of women using VHA maternity benefits were age 30 or older and had a service-connected disability. From FY 2008 to 2012, the VHA paid more than $46 million in delivery claims to community providers for deliveries to women veterans ($4,993/veteran).


CONCLUSIONS
Over a 5-year period, the volume of women veterans using VHA maternity benefits increased by 44%. Given this sizeable increase, the VHA must increase its capacity to care for pregnant veterans and ensure care coordination systems are in place to address the needs of pregnant veterans with service-connected disabilities.
Research and Development, VA Central Western Massachusetts, Leeds, Massachusetts; Department of Quantitative Health Science, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: Kristin.Mattocks@va.gov.
Kristin M
KM
Mattocks
Center for Health Care Evaluation, VA HSR&D Center of Excellence, VA Palo Alto Health Care System, Palo Alto, California; Division of General Medical Disciplines, Stanford University, Palo Alto, California; Center for Primary Care and Outcomes Research, Stanford University, Palo Alto, California.
Susan
S
Frayne
Health Economics Resource Center, VA Palo Alto Health Care System Center for Health Care Evaluation, VA Palo Alto Health Care System, Palo Alto, California; Department of Pediatrics, Stanford University School of Medicine, Center for Primary Care and Outcomes Research, Stanford University School of Medicine.
Ciaran S
CS
Phibbs
VA Greater Los Angeles HSR&D Center of Excellence for the Study of Healthcare Provider Behavior, Sepulveda, California; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California.
Elizabeth M
EM
Yano
Director, Reproductive Health, Women's Health Services, Office of Patient Care Services, Department of Veterans Affairs, New York, New York.
Laurie
L
Zephyrin
VHA Chief Business Office, Purchased Care - Program Oversight and Informatics, Denver, Colorado.
Holly
H
Shryock
VA Connecticut Healthcare System, Yale University School of Medicine, West Haven, Connecticut.
Sally
S
Haskell
VA Puget Sound Health Care System, Seattle, Washington; Department of Health Services, University of Washington, School of Public Health, Seattle, Washington.
Jodie
J
Katon
VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts.
J Cherry
JC
Sullivan
Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts.
Linda
L
Weinreb
University of Massachusetts Medical School, Worcester, Massachusetts.
Christine
C
Ulbricht
VA Connecticut, Newington, Connecticut; Division of General Internal Medicine, University of Connecticut, Farmington, Connecticut.
Lori A
LA
Bastian
D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000191:economics* / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006801:Humans; D007342:Insurance Benefits / Q000706:statistics & numerical data* / Q000639:trends; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data*; D014728:Veterans / Q000706:statistics & numerical data*; D014932:Women's Health Services / Q000706:statistics & numerical data*; D055815:Young Adult