Evolving comprehensive VA women's health care: patient characteristics, needs, and preferences.

BACKGROUND Assessment of women veterans' health needs and preferences and their care environment have been identified as a priority research need by the national Veterans Affairs (VA) Women's Health research agenda. Our objective was to identify women veterans' health care preferences and perceptions associated with sole or dual VA health care use. METHODS This cross-sectional study of 1,002 VA-enrolled Midwestern veterans was performed by computer-assisted telephone interviews. RESULTS Sole and dual (both VA and non-VA) users of VA care were more likely to have served in a combat area, have a current diagnosis of posttraumatic stress disorder, and poorer physical health scores than non-VA users. Non-VA users were more likely to be married and have private health insurance. Sole VA users were more likely to want a choice of a male or female health care provider. Both sole and dual VA users believed that the VA provides adequate privacy and safety during outpatient examinations compared with non-users. Urban women veterans were more likely to endorse specific environment of care preferences such as gender-specific waiting areas compared with rural veterans. CONCLUSION Care preferences were similar regardless of VA use; however, perceptions of VA care varied. Women using VA care solely had the most positive perceptions of VA care, followed by dual users then non-VA users. Rural women were similar to urban veterans, but were less likely to endorse specific care preferences. Considering these differences with regard to need and access can inform VA policy and initiatives on improving access to and use of VA care among women veterans in urban and rural areas.