The Burden of Illness in the First Year Home: Do Male and Female VA Users Differ in Health Conditions and Healthcare Utilization
The Burden of Illness in the First Year Home: Do Male and Female VA Users Differ in Health Conditions and Healthcare Utilization
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DOI：
10.1016/j.whi.2010.08.001
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发表时间：
2011-01-01
影响因子：
3.2
通讯作者：
Brandt, Cynthia
中科院分区：
文献类型：
--
作者：
Haskell, Sally G.;Mattocks, Kristin;Brandt, Cynthia
背景：我们试图描述在伊拉克和阿富汗战争后第一年使用退伍军人健康管理局(VA)服务的退伍军人在医疗和心理健康状况和医疗保健利用方面的性别差异。方法：这是一项观察性研究，使用退伍军人健康管理局(VA)管理和临床数据库，对163,812名参加过VA并在最后一次部署后一年内至少去过一次的退伍军人进行了观察性研究。结果：女性退伍军人略年轻(平均年龄30岁对男性32岁；P<；.0001)，非洲裔美国人的可能性(30%对15%；P<；以及更不可能结婚(32%比49%；p<；.0001)。女性去初级保健(2.6比2.0；P<；.001)和精神健康(4.0比3.6：P<；.001)诊所就诊的次数更多，对退伍军人事务部以外的社区护理的使用率更高(14%比10%；P<；.001)。在对显著的人口统计学差异进行调整后，女性更有可能患有肌肉骨骼和皮肤疾病、轻度抑郁症、重度抑郁症和适应障碍，而男性更有可能患有耳朵障碍和创伤后应激障碍。13%的女性寻求妇科检查，10%的女性寻求避孕咨询，7%的女性寻求月经紊乱。结论：退伍军人女性的身体状况相似，但某些心理健康障碍的比例较高，并将退伍军人退伍军人用于生殖健康需求。他们的医疗保健服务使用率也略高一些。这些调查结果突出了女性退伍军人保健的复杂性，并支持在退伍军人事务部内发展增强的全面妇女保健服务。版权所有(C)2011年，由雅各布斯妇女健康研究所所有。由爱思唯尔公司出版。
Background: We sought to describe gender differences in medical and mental health conditions and health care utilization among veterans who used Veterans Health Administration (VA) services in the first year after combat in Iraq and Afghanistan.Methods: This is an observational study, using VA administrative and clinical data bases, of 163,812 Operation Enduring Freedom/Operation Iraqi Freedom veterans who had enrolled in VA and who had at least one visit within 1 year of last deployment.Results: Female veterans were slightly younger (mean age, 30 years vs. 32 for men; p < .0001), twice as likely to be African American (30% vs. 15%; p < .0001), and less likely to be married (32% vs. 49%; p < .0001). Women had more visits to primary care (2.6 vs. 2.0; p < .001) and mental health (4.0 vs. 3.6: p < .001) clinics and higher use of community care outside the VA (14% vs. 10%; p < .001). After adjustment for significant demographic differences, women were more likely to have musculoskeletal and skin disorders, mild depression, major depression, and adjustment disorders, whereas men were more likely to have ear disorders and posttraumatic stress disorder. Thirteen percent of women sought care for gynecologic examination, 10% for contraceptive counseling, and 7% for menstrual disorders.Conclusion: Female veterans had similar rates of physical conditions, but higher rates of some mental health disorders and additionally, used the VA for reproductive health needs. They also had slightly greater rates of health care service use. These findings highlight the complexity of female Veteran health care and support the development of enhanced comprehensive women's health services within the VA. Copyright (C) 2011 by the Jacobs Institute of Women's Health. Published by Elsevier Inc.