# Presentation: 431289

## Progress in   Women Veterans HealthPatty Hayes, PhDChief Consultant,Women Veterans Health Strategic Health Care Group Summit 2008

## Women Veterans 

-  Women now comprise 14% of active duty deployed forces - and are becoming veterans at an increasing rate
- During Gulf War I (1991) Women were 10% of Deployed Active Duty, 5% of forces overall
- From WWII- Vietnam era, women comprised between 3-5% of Active Duty

**Notes:**
The important role of women in our nation’s defense and as part of the veteran population over the years cannot be over-stated.  Their history is a glorious one and sadly one not always acknowledged or appreciated. 

## THEN AND NOW

**Notes:**
Women have served in the military since the Revolutionary War when they disguised themselves as men...and were only afforded full veteran status in the 1960’s.  
WASPS in WWII 
Airwomen in PG War

## Mission: Quality Women’s Health In VA

- Provide highest quality health care to every woman veteran
- Each woman veteran presenting at VA will be assured that her gender-specific primary care needs will be met by a proficient and interested primary care provider
- Highest quality: includes privacy, dignity, and sensitivity to all health needs
- Highest quality: is providing the right care in the right place and time

## Women Veterans Using VA 

**Notes:**
First all women air squadron in Gulf- Reserve re-fueling group, 2003 over Baghdad

## The New OIF/OEF Era Veteran

- She is utilizing VA services: 42% enroll
- She is coming to VA frequently
- 45% were seen 2-10 visits
- 38.5 % seen 11 or more times since 2003
- VHA Challenge:
- The total number of women using VA services will nearly double in the next 2-4 years.
- 	How will VHA best provide health services as the numbers increase?

## Women Veterans Program Evolution Since Summit 2004

- Accomplishments: Gender-specific care
- Adoption of Performance Measures/goals
- Breast CA mammograms > 86% compliance
- Cervical Ca Screening > 90% compliance
- Bone density for Osteoporosis risk- ongoing  measures
- New purchases this year, now  DEXA machines in nearly every VA
- Delivery of care models:
- Most frequent: Mixed gender Primary Care with separate visit to GYN (43%)
- Research data on patient satisfaction with specific delivery models: Highest in women’s primary care clinics that also provide GYN care
- We are working quickly towards more women’s health Primary  Care Clinics

**Notes:**
Delivery of care models measured Clinical/Plan of Care inventory:
Separate women’s health center providing comprehensive, multidisciplinary care that includes primary care, gender-specific care, mental health services and surgical services (i.e. Breast clinic or Gyn/colposcopy clinic) within a designated space. (14%)
Separate women’s health center providing primary care and gender- specific care within a designated space. (19%)
Separate gender-specific and/or gynecology clinic, primary care provided in a designated women’s primary care team within the facility. (8%)
Separate gender-specific and/or gynecology clinic, primary care provided in mixed gender primary care teams within the facility. (43%)
Integrated. Gender-specific and primary care provided in mixed gender primary care teams within the facility (16%)

## President George W. Bush visits troops, 

- President George W. Bush visits troops,
- Labor Day weekend, Sept 2007
- Washington Post photo

## Women’s Health Moves Forward

- Dr Kussman elevated office from Women Veterans Health Program to Women Veterans Health Strategic Health Care Group in March, 2007
- Moves focus beyond gender-specific care such as Pap Smears to comprehensive care of women - and women’s health as a subpopulation of all veterans
- Increased focus on quality of care issues and comprehensive longitudinal care for women veterans
- Follow health of women over time and track effects of  deployments on women veterans

## Women Veterans Using VA

## Earlier Eras of Service: WWII, Korea, Vietnam, Gulf War IDifferent Needs

- We don’t lose sight of our “aging women”
- Significant numbers over age 55 use VA
- Cardiac risk : the number one risk for morbidity and mortality in women
- High prevalence of diabetes and obesity
- Health concerns of peri-menopause and menopause
- Cancer screenings –breast, lung,
- colorectal, cervical cancers

**Notes:**
Over age 55 = 70,000 women

## You  Served  -  You Deserve

## You  Served  -  You Deserve

- At VA, our mission is to provide you the _BEST_ health care available anywhere in the country.