Strategies for transforming reproductive healthcare delivery in an integrated healthcare system: A national model with system-wide implications

Current Opinion in Obstetrics and Gynecology

Volumn 26, Issue 6, 2014, Pages 503-510

  Zephyrin, Laurie C ^a,b   Katon, Jodie G ^a,c,d   Yano, Elizabeth M ^e,f  

^a DEPARTMENT OF VETERANS AFFAIRS   (United States)

^b NEW YORK UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c VA PUGET SOUND HEALTH CARE SYSTEM   (United States)

^d UNIVERSITY OF WASHINGTON   (United States)

^e VA GREATER LOS ANGELES HEALTHCARE SYSTEM   (United States)

^f UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

Health policy; Health system; Programmatic development; Reproductive health; Women Veterans

Indexed keywords

CLINICAL RESEARCH; ELECTRONIC MEDICAL RECORD; EMERGENCY HEALTH SERVICE; HEALTH CARE DELIVERY; HEALTH CARE PERSONNEL; HEALTH CARE POLICY; HEALTH PROGRAM; HEALTH SERVICE; HUMAN; INTEGRATED HEALTH CARE SYSTEM; MATERNAL CARE; PRIORITY JOURNAL; REPRODUCTIVE HEALTH; REVIEW; VETERANS HEALTH; FEMALE; GOVERNMENT; HEALTH CARE QUALITY; INTERDISCIPLINARY COMMUNICATION; ORGANIZATION; ORGANIZATION AND MANAGEMENT; PUBLIC-PRIVATE PARTNERSHIP; UNITED STATES; WOMEN'S HEALTH;

DELIVERY OF HEALTH CARE, INTEGRATED; FEMALE; HEALTH CARE REFORM; HUMANS; INTERDISCIPLINARY COMMUNICATION; ORGANIZATIONAL INNOVATION; PUBLIC-PRIVATE SECTOR PARTNERSHIPS; QUALITY OF HEALTH CARE; REPRODUCTIVE HEALTH SERVICES; UNITED STATES; UNITED STATES DEPARTMENT OF VETERANS AFFAIRS; VETERANS HEALTH; WOMEN'S HEALTH;

EID: 84928093506     PISSN: 1040872X     EISSN: 1473656X     Source Type: Journal    
DOI: 10.1097/GCO.0000000000000124     Document Type: Review

References (33)

1. Department of Veterans Affairs. The veteran population projection model [VetPop2011]. http://www.va.gov/vetdata/Veteran-Population.asp; 2011.
2. Fiscal Year 2014 1st Quarter pocket card: http://vaww.va.gov/VHAOPP/ vast3.asp; 2014.
3. Frayne SM, Phibbs C, Saechao F, et al. Sourcebook: Women Veterans in the Veterans Health Administration. Volume 3. Sociodemographics, Utilization, Costs of Care, and Health Profile. Women's Health Evaluation Initiative. Women's Health Services, Veterans Health Administration, Department of Veterans Affairs. http://www.womenshealth.va.gov/WOMENSHEALTH/ latestinformation/publications.asp; 2014. Summary of the health profile and healthcare utilization of women Veterans using Veterans Health Administration (VHA) healthcare. The report compares the healthcare needs of men and women Veterans using VHA healthcare, including differences by sex and age group. Notably, among women Veterans of childbearing age using VHA healthcare reproductive healthcare was one of the top three healthcare needs.
4. Frayne SM, Phibbs C, Friedman SA, et al. Sourcebook: Women Veterans in the Veterans Health Administration. Volume 2. Sociodemographics and Use of VHA and Non-VA Care (Fee). Women's Health Evaluation Initiative. Women's Health Services, Veterans Health Administration, Department of Veterans Affairs. http://www.womenshealth.va.gov/WOMENSHEALTH/ latestinformation/publications.asp; 2012.
5. Friedman SA, Phibbs CS, Schmitt SK, et al. New women veterans in the VHA: a longitudinal profile. Womens Health Issues 2011; 21 (Suppl 4):S103-S111.
6. Zephyrin L, Katon J, Hoggatt K, et al. State of Reproductive Health in Women Veterans-VA Reproductive Health Diagnoses and Organization of Care. Women's Health Services. Department of Veterans Affairs. http://www. womenshealth.va.gov/WOMENSHEALTH/latestinformation/publications.asp; 2014. Summary of the reproductive health needs of women Veterans using VHA healthcare. The report identifies the top five reproductive health needs by age group (18-44, 45-64, and -65 years old). Additionally, data are provided describing how women's healthcare is organized within VHA and a vision for continued expansion of VHA reproductive healthcare is outlined.
7. VA Healthcare for Women Veterans. www.womenshealth.va.gov; 2014.
8. VHA handbook 1330.01: Healthcare services for women veterans: http:// www.va.gov/vhapublications/ViewPublication.asp?pub-ID=2246; 2010.
9. World Health Organization Reproductive Health. http://www.who.int/topics/ reproductive-health/en/.
10. Mishra GD, Anderson D, Schoenaker DA, et al. InterLACE: A new international collaboration for a life course approach to women's reproductive health and chronic disease events. Maturitas 2013; 74:235-240.
11. Mishra GD, Cooper R, Kuh D. A life course approach to reproductive health: theory and methods. Maturitas 2010; 65:92-97.
12. Lu MC. Healthcare reform and women's health: a life-course perspective. Curr Opin Obstet Gynecol 2010; 22:487-491.
13. Lehavot K, Hoerster KD, Nelson KM, et al. Health indicators for military, veteran, and civilian women. Am J Prev Med 2012; 42:473-480.
14. Mengeling MA, Sadler AG, Torner J, Booth BM. Evolving comprehensive VA women's healthcare: patient characteristics, needs, and preferences. Womens Health Issues 2011; 21 (Suppl 4):S120-S129.
15. Zinzow HM, Grubaugh AL, Monnier J, et al. Trauma among female veterans: a critical review. Trauma Violence Abuse 2007; 8:384-400.
16. Kimerling R, Gima K, Smith MW, et al. The Veterans Health Administration and military sexual trauma. Am J Public Health 2007; 97:2160-2166.
17. Military Sexual Trauma Screening Report. Department of Veteran Affairs, Patient Care Services, Office of Mental Health Services; Fiscal Year 2011.
18. Street AE, Vogt D, Dutra L. A new generation of women veterans: stressors faced by women deployed to Iraq and Afghanistan. Clin Psychol Rev 2009; 29:685-694.
19. Frayne SM, Phibbs C, Friedman SA, et al. Sourcebook: Women Veterans in the Veterans Health Administration. Volume 1. Sociodemographic Characteristics and Use of VHA Care. Women's Health Evaluation Initiative. Women's Health Services, Veterans Health Administration, Department of Veterans Affairs. http://www.womenshealth.va.gov/WOMENSHEALTH/ latestinformation/publications.asp; 2010.
20. Yano EM, Bastian LA, Bean-Mayberry B, et al. Using research to transform care for women veterans: advancing the research agenda and enhancing research-clinical partnerships. Womens Health Issues 2011; 21 (Suppl 4): S73-S83.
21. Yano EM, Bastian LA, Frayne SM, et al. Toward a VA women's health research agenda: setting evidence based priorities to improve the health and healthcare of women veterans. J Gen Intern Med 2006; 21:S93-S101.
22. Clancy CM. Emergency departments in crisis: implications for quality and safety. Am J Med Qual 2007; 22:59-62.
23. Cordasco KM, Zephyrin LC, Kessler CS, et al. An inventory of VHA emergency departments' resources and processes for caring for women. J Gen Intern Med 2013; 28 (Suppl 2):S583-S590. This manuscript presents a summary of the resources and processes for conditions specific to or more common in women in all 120 VHA EDs. Although nearly nine out of 10 EDs reported having key gynecologic equipment (e.g., exam tables, specula) available, fewer than two-fifths reported 24/7 availability of transpelvic ultrasound and only one-third had 24/7 availability of gynecology consultation. Resources and processes were more available in EDs with more encounters by women, more ED staffed beds, and those located in more complex facilities in metropolitan areas.
24. Under Secretary for Health's Information Letter: Guidance on Emergency Medical Services for Women. Washington, DC: Department of Veterans Affairs. http://www.va.gov/vhapublications/ViewPublication.asp?pub-ID= 2997; 2014.
25. Mattocks KM, Frayne S, Phibbs CS, et al. Five-year rends in Women Veterans' Use of VA Maternity Benefits, 2008-2012. Womens Health Issues 2012; 24:e37-e42. This manuscript reports on trends in use of Veterans VHA maternity benefits during the 5-year period between 2008 and 2012. Between 2008 and 2012 the delivery rate increased by 44% over the study period from 12.4 to 17.8 deliveries per 1000 women Veterans. The majority of women using VHA maternity benefits were aged 30 years or older and had a service-connected disability.
26. Mattocks KM, Skanderson M, Goulet JL, et al. Pregnancy and mental health among women veterans returning from Iraq and Afghanistan. J Womens Health 2010; 19:2159-2166.
27. Katon J, Zephyrin L, Cordasco KM, et al. Use of Veterans Health Administration prenatal care and resuming VA care following delivery. In: Academy Health Special Session on Gender and Health. Baltimore, Maryland; 2013.
28. Katon J, Mattocks K, Zephyrin L, et al. Gestational diabetes and hypertensive disorders of pregnancy among women veterans deployed in service of operations in Afghanistan and Iraq. J Womens Health 2014. [Epub ahead of print] This manuscript reports on the prevalence of gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP) among women Veterans deployed in service of operations in Afghanistan and Iraq (OEF/OIF/OND) who used VA maternity benefits. Using a nationally representative sample of deliveries from the Nationwide Inpatient Sample standardized incidence ratios (SIRs) adjusted for age and year of delivery were calculated to compare prevalence of GDM and HDP among OEF/OIF/OND women Veterans and non-Veterans. Compared with women delivering in the United States, OEF/OIF/OND Veterans using VA maternity benefits had higher risk of developing GDM (SIR: 1.40; 95% confidence interval 1.16, 1.68) and HDP (SIR: 1.32; 95% confidence interval 1.15, 1.51).
29. Buescher PA, Roth MS, Williams D, Goforth CM. An evaluation of the impact of maternity care coordination on Medicaid birth outcomes in North Carolina. Am J Public Health 1991; 81:1625-1629.
30. VHA Handbook 1330.03: Maternity Healthcare and Coordination. http:// www.va.gov/vhapublications/ViewPublication.asp?pub-ID=2803; 2012.
31. VA Healthcare Utilization by Recent Veterans. Analysis of VA Healthcare Utilization among 197 735 Female and 1 488 053 Male Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) Veterans: http://www.publichealth.va.gov/epidemiology/reports/oefoifond/ health-care-utilization/. 2014.
32. Mental health aspects of women's reproductive health: a global review of the literature. World Health Organization. http://whqlibdoc.who.int/publications/ 2009/9789241563567-eng.pdf; 2009.
33. Schwarz EB, Longo LS, Zhao X, et al. Provision of potentially teratogenic medications to female veterans of childbearing age. Med Care 2010; 48:834-842.