New research initiative seeks to speed up implementation of health care policy for women veterans

Wolters Kluwer HealthMar 17 2015

As more women veterans seek health care in the Veterans Administration (VA) system, effective approaches are needed to ensure that their unique needs are recognized and met. A special April supplement to Medical Care collects new studies from an ongoing research initiative to inform health care policy for women veterans. The journal is published by Wolters Kluwer.

"The goal of this supplement is to disseminate new research findings related to the planning, organization, financing, provision, evaluation and improvement of health services and/or outcomes for women veterans and women actively serving in the military," according to an introductory editorial. Guest Editors for the special issue were drawn from the VA Women's Health Research Network, led by Lori A. Bastian, MD, MPH, of the VA Connecticut Healthcare System, West Haven. The supplement was sponsored by the VA Health Services Research & Development (HSR&D) Service in the Office of Research and Development.

Research to Guide Policy on Health Care for Women Veterans

The number of women veterans receiving care in the VA system has more than doubled, making it essential to understand and introduce system-wide policies to meet their health care needs. The 21 studies in the special issue provide new data to guide policy in areas identified by the VA HSR&D Service's Women's Health Research agenda, including:

• Access to care and rural health. Studies identify key barriers faced by women veterans in accessing VA services, such as long driving distances, lack of knowledge about VA enrollment and healthcare services, and individual factors like unemployment and depression.

• Primary care and prevention. One paper provides an update on policies to direct women veterans to "designated women's health providers" within the VA system. Another draws attention to harmful health habits in women veterans--particularly smoking.

• Reproductive health. New research highlights the need for comprehensive care for reproductive health problems for women veterans in all age groups. Access to infertility services is a key issue for younger veterans.

• Mental health. Papers highlight the special needs for mental health services among women in the VA system. One study reports on the high prevalence of intimate partner violence; another notes differences between male and female veterans with posttraumatic stress disorder.

• Military service and deployment. Studies address health concerns related to service and deployment in women veterans, including race- and gender-based discrimination and the acute and chronic impact of military sexual assault.

• Complex chronic conditions, aging, and long-term care. A study reports that while the number of breast cancer cases seen in the VA system is increasing, more are being diagnosed at an earlier ("node-negative") stage

A final section on using research evidence to transform women veterans' health and health care identifies "top priority recommendations" for providing gender-sensitive care in each area of comprehensive women's health care. These recommendations can help to guide quality improvement efforts, but will require "multi-level engagement of a broad array of key stakeholders."

In an editorial, David Atkins, MD, MPH, and Linda Lipson, MA, of the HSR&D Service highlight important issues for further research in the wake of the 2014 Veterans Choice Act, which broadens veterans' access to health care services. Kristin Mattocks, PhD, of VA Central Western Massachusetts, Leeds, discusses the policy challenges of coordinating care for women veterans using dual health care systems--both inside and outside the VA.

Elizabeth M. Yano, PhD, MSPH, of the VA Greater Los Angeles HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy reports on the Women's Health Collaborative Research to Advance Transformation and Excellence (CREATE)--a new "partnered research initiative" seeking to accelerate the implementation of comprehensive care for women veterans. The guest editors conclude, "Researchers should continue to engage in effective partnerships with clinical and administrative leaders within the VA to ensure that research is fully capable of informing improvements in clinical care and advancing evidence-based policy," the editors conclude.