Adult Health Department, School of Nursing, West Virginia University, Morgantown, West Virginia.
Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia.
Nurs Forum. 2020 Apr;55(2):165-173. doi: 10.1111/nuf.12411. Epub 2019 Nov 14.
This study aimed to describe the five-year trend in healthcare access, health-related quality of life (HRQoL), and health outcomes in women Veterans.
A retrospective, pooled, cross-sectional study design was employed. Five-year trend was assessed using 2013 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) data. Bivariate, multivariable logistic regression, and ordinary least squares regression analyses were conducted.
A total of 6561 women Veterans, aged 18 to 64 years (3534 in 2013 and 3027 in 2017) were included. Compared to 2013, more women Veterans in 2017 reported increased healthcare insurance and decreased cost as a barrier to care. Women Veterans with health insurance were less likely to report cost as a barrier to care. There were no statistically significant differences in HRQoL in bivariate or ordinary least squares regression analyses between BRFSS years.
Federal policy and Veterans Health Administration expansion have had an impact on improving healthcare access to women Veterans. However, increased healthcare access alone does not translate into improved HRQoL or health outcomes for women Veterans. Future policies should not only focus on increasing healthcare access, but also improving health outcomes, especially HRQoL. The quality of the healthcare accessed must be a focus for future research and policy.
本研究旨在描述女性退伍军人在五年内获得医疗保健、与健康相关的生活质量(HRQoL)和健康结果的趋势。
采用回顾性、汇总、横断面研究设计。使用 2013 年和 2017 年行为风险因素监测系统(BRFSS)数据评估五年趋势。进行了双变量、多变量逻辑回归和普通最小二乘回归分析。
共纳入 6561 名年龄在 18 至 64 岁之间的女性退伍军人(2013 年 3534 名,2017 年 3027 名)。与 2013 年相比,2017 年更多的女性退伍军人报告增加了医疗保险,并减少了医疗费用作为获得医疗保健的障碍。有医疗保险的女性退伍军人报告费用是获得医疗保健的障碍的可能性较小。在 BRFSS 年份的双变量或普通最小二乘回归分析中,HRQoL 没有统计学差异。
联邦政策和退伍军人健康管理局的扩张对改善女性退伍军人的医疗保健获取产生了影响。然而,获得更多的医疗保健本身并不能转化为女性退伍军人的 HRQoL 或健康结果的改善。未来的政策不仅应关注增加医疗保健的获取,还应关注改善健康结果,特别是 HRQoL。所获得的医疗保健的质量必须是未来研究和政策的重点。