Characterization and Comparison of Physical and Mental Health Profiles and Department of Veterans Affairs Health Care Utilization Patterns among Operation Iraqi Freedom/Operation Enduring Freedom Women Veterans in Puerto Rico versus the United States.


Journal

Women's health issues : official publication of the Jacobs Institute of Women's Health
ISSN: 1878-4321
Titre abrégé: Womens Health Issues
Pays: United States
ID NLM: 9101000

Informations de publication

Date de publication:
Historique:
received: 19 02 2019
revised: 21 10 2019
accepted: 22 10 2019
pubmed: 5 12 2019
medline: 7 7 2020
entrez: 5 12 2019
Statut: ppublish

Résumé

Research on the physical and mental health profiles and patterns of health care use among women veterans receiving health care from the Department of Veterans Affairs (VA) on the island of Puerto Rico is lacking. This cross-sectional study examines differences in physical and mental health conditions, and patterns of VA health care use, between women veterans of the Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) era who were using VA facilities in Puerto Rico (n = 897) and those using U.S.-based VA facilities (n = 117,216) from 2002 to 2015. Results of fully adjusted logistic regression models revealed that OIF/OEF women in Puerto Rico had heightened risk for global pain-related disorders (i.e., any pain) (adjusted odds ratio [AOR], 1.45; 95% confidence interval [CI], 1.22-1.71), back pain (AOR, 1.83; 95% CI, 1.56-2.14), diabetes (AOR, 1.42; 95% CI, 1.03-1.95), hyperlipidemia (AOR, 3.34; 95% CI, 2.80-3.98), major depression (AOR, 1.78; 95% CI, 1.53-2.06), and bipolar depression (AOR, 1.66; 95% CI, 1.34-2.04). They also evidenced greater risk for a host of reproductive health conditions and had higher average annual use of VA health care than their U.S. counterparts. OIF/OEF women receiving VA health care in Puerto Rico evidenced a greater burden of physical illness, depression, and heightened use of VA health care services relative to their U.S. counterparts. Providers' increased awareness of the physical and mental health care needs of this population is warranted. Research efforts that help to identify efficient and effective strategies to provide culturally tailored and/or personalized health care for this population could also be useful.

Sections du résumé

BACKGROUND
Research on the physical and mental health profiles and patterns of health care use among women veterans receiving health care from the Department of Veterans Affairs (VA) on the island of Puerto Rico is lacking.
METHODS
This cross-sectional study examines differences in physical and mental health conditions, and patterns of VA health care use, between women veterans of the Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) era who were using VA facilities in Puerto Rico (n = 897) and those using U.S.-based VA facilities (n = 117,216) from 2002 to 2015.
RESULTS
Results of fully adjusted logistic regression models revealed that OIF/OEF women in Puerto Rico had heightened risk for global pain-related disorders (i.e., any pain) (adjusted odds ratio [AOR], 1.45; 95% confidence interval [CI], 1.22-1.71), back pain (AOR, 1.83; 95% CI, 1.56-2.14), diabetes (AOR, 1.42; 95% CI, 1.03-1.95), hyperlipidemia (AOR, 3.34; 95% CI, 2.80-3.98), major depression (AOR, 1.78; 95% CI, 1.53-2.06), and bipolar depression (AOR, 1.66; 95% CI, 1.34-2.04). They also evidenced greater risk for a host of reproductive health conditions and had higher average annual use of VA health care than their U.S. counterparts.
CONCLUSIONS
OIF/OEF women receiving VA health care in Puerto Rico evidenced a greater burden of physical illness, depression, and heightened use of VA health care services relative to their U.S. counterparts. Providers' increased awareness of the physical and mental health care needs of this population is warranted. Research efforts that help to identify efficient and effective strategies to provide culturally tailored and/or personalized health care for this population could also be useful.

Identifiants

pubmed: 31796346
pii: S1049-3867(19)30480-3
doi: 10.1016/j.whi.2019.10.004
pii:
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

49-56

Informations de copyright

Published by Elsevier Inc.

Auteurs

Julie C Weitlauf (JC)

Veterans Affairs Palo Alto Health Care System, Center for Innovation to Implementation (CI2I), Menlo Park, California; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California. Electronic address: wjulie1@stanford.edu.

Ana Ortiz (A)

Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico & University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.

Aimee R Kroll-Desrosiers (AR)

Departments of Quantitative Health Sciences, Psychiatry and Family Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.

Mabel E Quiñones Vázquez (ME)

Veterans Affairs Caribbean Health Care System, San Juan, Puerto Rico.

Brad Cannell (B)

School of Public Health, University of Texas Health Science Center at Houston, Dallas, Dallas, Texas.

Mayra N Berrios Hernandez (MNB)

Veterans Affairs Caribbean Health Care System, San Juan, Puerto Rico.

Cynthia Brandt (C)

Veterans Affairs Connecticut Health Care System, West Haven, Connecticut; Department of Emergency Medicine, Yale University, New Haven, Connecticut.

Kristin Mattocks (K)

Departments of Quantitative Health Sciences, Psychiatry and Family Medicine, University of Massachusetts Medical School, Worcester, Massachusetts; Veterans Affairs Central Western Massachusetts Health Care System, Leeds, Massachusetts.

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