Tailoring VA Primary Care to Women Veterans: Association with Patient-Rated Quality and Satisfaction

Washington, Donna L.; Bean-Mayberry, Bevanne; Mitchell, Michael N.; Riopelle, Deborah; Yano, Elizabeth M.

doi:10.1016/j.whi.2011.04.004

Cited by 46 publications

(39 citation statements)

References 20 publications

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“…These results suggest that women's primary care clinics, which are available at many VHA facilities, are a strategic setting to enhance implementation of women's mental health services through integration of primary care and mental health care (36). These data are also consistent with prior research that has found that designated women's primary care services are associated with greater satisfaction among female veterans (37,38), as well as higher ratings of patient centeredness, such as patient-provider communication, provider's interest in mental health, provider's expertise with women, and shared decision making (39). Future research should examine whether meeting these preferences is similarly associated with greater engagement and satisfaction with mental health services.…”

Section: Discussionsupporting

confidence: 81%

Patient-Centered Mental Health Care for Female Veterans

Kimerling¹,

Bastian²,

Bean-Mayberry³

et al. 2015

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Objective-Mental health services for women vary widely across the Veterans Health Administration (VHA) system, without consensus on the need for, or organization of, specialized services for women. Understanding women's needs and priorities is essential to guide the implementation of patient-centered behavioral health services.Methods-In a cross-sectional, multisite survey of female veterans using primary care, potential stakeholders were identified for VHA mental health services by assessing perceived or observed need for mental health services. These stakeholders (N=484) ranked priorities for mental health care among a wide range of possible services. The investigators then quantified the importance of having designated women's mental health services for each of the mental health services that emerged as key priorities.Portions of this article were presented at the annual research meeting of the Academy Health, Baltimore, June 23-25, 2013.The authors report no financial relationships with commercial interests. U.S. Department of Veterans Affairs VA Author ManuscriptVA Author Manuscript VA Author ManuscriptResults-Treatment for depression, pain management, coping with chronic general medical conditions, sleep problems, weight management, and posttraumatic stress disorder (PTSD) emerged as women's key priorities. Having mental health services specialized for women was rated as extremely important to substantial proportions of women for each of the six prioritized services. Preference for primary care colocation was strongly associated with higher importance ratings for designated women's mental health services. For specific types of services, race, ethnicity, sexual orientation, PTSD symptoms, and psychiatric comorbidity were also associated with higher importance ratings for designated women's services.Conclusions-Female veterans are a diverse population whose needs and preferences for mental health services vary along demographic and clinical factors. These stakeholder perspectives can help prioritize structural and clinical aspects of designated women's mental health care in the VHA.Implementation of patient-centered behavioral health services in primary care is improving the quality of mental health care in the Veterans Health Administration (VHA) (1) and may be especially effective in improving the quality of care for underrepresented populations (2-5). For example, a patient-centered approach helps address the unique mental health needs of women in VHA care, who constitute only 6% of all veteran users in a predominantly male system (6,7) but who are one of the most rapidly growing subpopulations of patients within the VHA (8). Historically, women utilizing VHA services have faced gender disparities in access to and quality of primary care, preventive services, and mental health care (9,10), which led to the implementation of comprehensive primary care for female veterans across the system (11,12). Mental health services for women still vary across the VHA, without consensus on the need for, or org...

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Section: Discussionsupporting

confidence: 81%

Patient-Centered Mental Health Care for Female Veterans

Kimerling¹,

Bastian²,

Bean-Mayberry³

et al. 2015

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“…36 Gender-sensitive measures of women veterans' experiences with PACT care should also be used to tailor PC to meet their needs. 37,38 Research-clinical partnerships may also help accelerate testing of innovative approaches to delivering the fundamental tenets of PACT to special populations, bringing evidence-based approaches to bear on these issues. [39][40][41] Key lessons may yield insights for ensuring that all veterans equitably benefit from the promise of PACT.…”

Section: Resultsmentioning

confidence: 99%

Delivery of Gender-Sensitive Comprehensive Primary Care to Women Veterans: Implications for VA Patient Aligned Care Teams

2014

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The Veterans Health Administration (VA) has undertaken a major initiative to transform primary care delivery through implementation of Patient Aligned Care Teams (PACTs). Based on the patient-centered medical home concept, PACTs aim to improve access, continuity, coordination, and comprehensiveness using teambased care that is patient driven and patient centered. However, how PACT principles should be applied to meet the needs of special populations, including women veterans, is not entirely clear. While historical differences in military participation meant women veterans were rarely seen in VA healthcare settings, they now represent the fastest growing segment of new VA users. They also have complex healthcare needs, adding gender-specific services and other needs to the spectrum of services that the VA must deliver. These trends are changing the VA landscape, introducing challenges to how VA care is organized, how VA providers need to be trained, and how VA considers implementation of new initiatives, such as PACT. We briefly describe the evolution of VA primary care delivery for women veterans, review VA policy for delivering gender-sensitive comprehensive primary care for women, and discuss the challenges that women veterans' needs pose in the context of PACT implementation. We conclude with recommendations for addressing some of these challenges moving forward.KEY WORDS: primary care; women's health; veterans.

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“…However, a small segment of VA users also have poor VA perceptions, implying a need to improve VA care, e.g., by tailoring it to women's needs and preferences. 25 Some women veterans are not eligible for VA care, or choose to obtain their healthcare in the private sector. VA nonusers, particularly the uninsured, are at risk for not receiving needed care.…”

Section: Discussionmentioning

confidence: 99%

Access to Care for Women Veterans: Delayed Healthcare and Unmet Need

et al. 2011

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Both general and veteran-specific factors impact women veterans' access to needed services. Many of the identified access barriers are potentially modifiable through expanded VA healthcare and social services. Health reform efforts should address these barriers for VA nonusers. Efforts are also warranted to improve women veterans' knowledge of availability and affordability of VA healthcare, and to enhance the gender-sensitivity of this care.

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Tailoring VA Primary Care to Women Veterans: Association with Patient-Rated Quality and Satisfaction

Cited by 46 publications

References 20 publications

Patient-Centered Mental Health Care for Female Veterans

Patient-Centered Mental Health Care for Female Veterans

Delivery of Gender-Sensitive Comprehensive Primary Care to Women Veterans: Implications for VA Patient Aligned Care Teams

Access to Care for Women Veterans: Delayed Healthcare and Unmet Need

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