Racial and Ethnic Health Care Disparities Among Women in the Veterans Affairs Healthcare System: A Systematic Review

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• 作者：Andrea Carter ; MD^aAuthor Vitae ; Sonya Borrero ; MD ; MS^a ; ^b ; ^{borrerosp@upmc.edu" class="auth_mail" title="E-mail the corresponding author}Author Vitae ; Charles Wessel ; MLS^cAuthor Vitae ; Donna L. Washington ; MD ; MPH^d ; ^eAuthor Vitae ; Bevanne Bean-Mayberry ; MD ; MHS^d ; ^eAuthor Vitae ; Jennifer Corbelli ; MD ; MS^aAuthor Vitae ; ; the VA Women's Health Disparities Research WorkgroupBryan C. Batch ; MD ; Jessica Y. Breland ; MS ; PhD ; Brooke DiLeone ; PhD ; Melissa Ming Foynes ; PhD ; Robin Keene ; PhD ; RN ; Leslie Hausmann ; PhD ; Kristen Mattocks ; PhD ; MPH ; Michelle Mengeling ; PhD ; MS ; Leslie Moreland ; PsyD ; Phyllis Nsiah-Kumi ; MD ; MPH ; Uche Uchendu ; MD ; Sharon Kelly West ; RN MHS ; CCE ; Karen Patricia Williams ; PhD ; Susan Zickmund ; PhD
• 刊名：Women's Health Issues
• 出版年：2016
• 出版时间：July-August 2016
• 年：2016
• 卷：26
• 期：4
• 页码：401-409
• 全文大小：342 K

文摘

Women are a rapidly growing segment of patients who seek care in the Veterans Affairs (VA) Healthcare System, yet many questions regarding their health care experiences and outcomes remain unanswered. Racial and ethnic disparities have been well-documented in the general population and among veterans; however, prior disparities research conducted in the VA focused primarily on male veterans. We sought to characterize the findings and gaps in the literature on racial and ethnic disparities among women using the VA.

Methods

We systematically reviewed the literature on racial and ethnic health care disparities exclusively among women using the VA Healthcare System. We included studies that examined health care use, satisfaction, and/or quality, and stratified data by race or ethnicity.

Results

Nine studies of the 2,591 searched met our inclusion criteria. The included studies examined contraception provision/access (n = 3), treatment of low bone mass (n = 1), hormone therapy (n = 1), use of mental health or substance abuse–related services (n = 2), trauma exposure and use of various services (n = 1), and satisfaction with primary care (n = 1). Five of nine studies showed evidence of a significant racial or ethnic difference.

Conclusion

In contrast with the wealth of literature examining disparities both among the male veterans and women in non-VA settings, only nine studies examine racial and ethnic disparities specifically among women in the VA Healthcare System. These results demonstrate that there is an unmet need to further assess health care disparities among female VA users.