Does a Welcoming Environment Influence Women Veterans' Primary Care Experiences?

Autor: Rose DE; VA HSR Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California. Electronic address: Danielle.Rose@va.gov., Farmer MM; VA HSR Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California., Oishi SM; VA HSR Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California., Klap RS; VA HSR Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California., Bean-Mayberry BA; VA HSR Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California; Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California; UCLA Fielding School of Public Health, Los Angeles, California., Canelo I; VA HSR Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California., Washington DL; VA HSR Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California., Yano EM; VA HSR Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California.
Jazyk: angličtina
Zdroj: Women's health issues : official publication of the Jacobs Institute of Women's Health [Womens Health Issues] 2024 Sep-Oct; Vol. 34 (5), pp. 540-548. Date of Electronic Publication: 2024 Aug 28.
DOI: 10.1016/j.whi.2024.07.002
Abstrakt: Background: A welcoming environment may influence patient care experiences, and it may be particularly relevant for underrepresented groups, such as women veterans at Veterans Health Administration (VA) facilities where they represent only 8-10% of patients. Challenges to ensuring a welcoming environment for women veterans may include unwelcome comments from male veterans and staff or volunteers and feeling unsafe inside or outside VA facilities. We assessed associations between reports of gender-related environment of care problems and patient-reported outcomes.
Procedures: We merged national patient-reported outcomes from women veterans (n = 4,961) using Consumer Assessment of Health Plans & Systems Patient Centered Medical Home (CAHPS-PCMH) survey composite measures with Women Veteran Program Managers' reports of gender-related environment of care problems (n = 127, 2016-2017) at VA facilities. We performed multilevel bivariate logistic regressions to assess associations between Women Veteran Program Managers' reports of large/extreme problems and likelihood of women veterans' optimal ratings of primary care experiences (access, coordination, comprehensiveness, provider communication, and overall rating of primary care provider). We adjusted for patient-, site-, and area-level characteristics, and clustering of patients within VA facilities, and we applied design weights to address nonresponse bias in the patient data. Response rates were 40% for women veterans and 90% for Women Veteran Program Managers.
Main Findings: Few (<15%) Women Veteran Program Managers reported large/extreme environment of care problems. Women veterans obtaining care at those sites were less likely to rate provider communication and comprehensiveness (psychosocial health assessed) as optimal.
Principal Conclusions: Ensuring a welcoming environment may improve women veterans' primary care experiences.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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