1005. Do Women Veterans Perceive Gender Disparities in VA Health Care
Donna L Washington, MD, MPH, VA Greater Los Angeles Healthcare System, S Kleimann, Kleimann Communication Group, AN Michelini, University of Cincinnati, K Kraft, Kleimann Communication Group, M Canning, VA Greater Los Angeles Healthcare System, WM Yano, VA Greater Los Angeles Healthcare System

Objectives: The expansion of women in the military is reshaping the veteran population and VA's healthcare delivery imperatives. Historically, the growing presence of women in VA highlighted gaps in women’s VA access and quality of care, and led to legislative and VA action to improve VA women’s healthcare. Our objective was to determine current women veteran perspectives and decision-making about VA healthcare use.

Methods: We conducted six women veteran focus groups (4 VA user, 2 non-user). Utilizing systematic qualitative methods, we clarified complex interactions among values, assumptions, experiences, and ascribed meanings in decision-making. Using grounded theory methodology, two investigators independently coded verbatim transcripts of the groups to identify key themes. To enhance reliability, two additional investigators recoded transcripts, and a third independently identified key themes.

Results: Barriers to VA use for both users and non-users included lack of information about eligibility and available services. Non-users often assumed the VA did not provide women’s healthcare. All groups emphasized they required a healthcare system focused on quality and sensitivity to women’s health issues. However, users and non-users differed in perceptions of VA quality. All groups described the VA as an older-male-dominated culture. VA environment and quality concerns led many women to limit their VA use to women’s clinics.

Conclusions: Women veterans’ perceptions and experiences of VA healthcare are sometimes gender-based, often outdated, and influence decisions about VA use.

Impact: Our findings suggest the need for dissemination of accurate information about VA eligibility and services, and continued responsiveness to women’s perceptions of care.