TUESDAY 17 JUNE 2008

Friday 13 June 2008

by: The Associated Press

Outpatient care at many VA facilities needs vast upgrade, officials say.

Washington - Women veterans aren't receiving the same quality of outpatient care as men at many Department of Veterans Affairs' facilities, according to an agency review obtained exclusively by The Associated Press.

The review appears to validate the complaints of advocates and some members of Congress who have said the health care system needs to focus more on women's health.

Women make up about 5 percent of the VA's population, but that number is expected to nearly double in the next two years as more women return home from Iraq and Afghanistan and seek care.

The review of the quality of care at VA facilities, which was mandated by Congress, found that at about one-third of its facilities, the quality of outpatient care given to women wasn't as good as what was offered to men.

It said that the VA has made strides in improving care for women veterans, such as creating onsite mammography services and establishing women's clinics at most of its medical centers. It also said the VA is attempting to recruit clinicians with training in women's care and broadening its approach to better address diseases prevalent among women such as lung cancer.

However, it said that there were barriers that remained, such as the need to train more physicians in women's care and for more equipment to meet women's health needs.

"VHA is continuing to investigate the possibility of gender disparity in delivery of care through research efforts aimed at further delineating the factors involved," the review said.

It noted that other studies have found better surgical outcomes and decreased mortality for women at VA hospitals compared to women who receive care under the Medicare Advantage Program or under private care. And, performance of breast and cervical cancer screening exceeds that of commercial and some government plans.

But Dr. William E. Duncan, associate deputy undersecretary for health for quality and safety at the Department of Veterans Affairs, said any discrepancies in VA care were unacceptable and the agency is aggressively addressing the issue.

"We're striving to understand the reason for these health disparities and to eliminate differences in veterans health care based on personal characteristics," Duncan said.

Data was not available to compare the inpatient quality of care between men and women.

Overall, women make up about 14 percent of the U.S. Armed Forces. Of the 1.7 million troops who have deployed in support of the wars in Iraq and Afghanistan, more than 190,000 - or about 11 percent - are women.

Among the Other Findings:

• Older and younger veterans appear to be receiving the same quality of care;

• About 86 percent of homeless veterans seen by VA received primary care, mental health care and/or substance abuse services;

• About 98 percent of appointments were completed within 30 days in primary care clinics and about 97 percent were completed during that period at specialty clinics;

• Overall quality of care appears to be good when reviewed using commonly accepted health care benchmarks;

• Minority veterans surveyed were generally less satisfied with inpatient and outpatient care than white veterans, but it wasn't clear if the quality of care offered was different. A more comprehensive study of care for minority veterans is expected to be complete this summer.