Patterns of Sex and Racial/Ethnic Differences in Patient Health Care Experiences in US Veterans Affairs Hospitals

Abstract

Male, black, and Hispanic patients treated in VA hospitals tend to report more positive experiences than female and white patients treated at the same facilities. However, less positive experiences are reported by patients overall in hospitals that serve larger populations of women and racial/ethnic minorities.

Racial Differences in Satisfaction with VA Health Care: A Mixed Methods Pilot Study

“…Our finding of lower levels of satisfaction with outpatient care among African Americans are consistent with the VA report that revealed racial differences in satisfaction with care at the VA [14] and other studies of veterans [46][47][48]. Based on such findings, the VA leadership has taken a proactive approach to understanding the underlying reasons for these differences.…”

Patient Activation and Mental Health Care Experiences Among Women Veterans

“…Veteran ratings of health care experiences for both inpatient and outpatient care vary across facilities (Hausmann et al 2014; Hausmann et al 2013), and our study did not focus on organizational or structural characteristics that impact these experiences. The care environment could potentially exert positive effects on patient activation or preference-concordant care through widespread and visible availability of desired services.…”

“…While few studies have examined mental health experiences specifically, examination of gender disparities in VHA care experiences indicate few differences in outpatient care experiences after case mix adjustment (Wright et al 2006). Some disparities exist for inpatient care, where women report poorer experiences as compared to men for care experiences that may be sensitive to patient activation, such as shared decision making, communication about medications, and communication of discharge information (Hausmann et al 2014). Women veterans report distinct gender-related preferences regarding mental health services (Kimerling et al 2014), such as preferences for female providers, women-only groups, or designated women’s treatment settings.…”

Racial Difference in the Use of VA Health Services

“…Besides, despite the improvement in procedural measures (Jha, Perlin, Kizer, & Dudley, 2003), there still is a racial gap in clinical outcomes even within a facility (Gao et al, 2011;Trivedi, Grebla, Wright, & Washington, 2011), albeit the minority isn't always disadvantaged (Volpp et al, 2007). Male and minority patients in VA hospitals also tend to have more positive experiences than female and white veterans (Hausmann, Gao, Mor, Schaefer, & Fine, 2014).…”

“…On the other hand, the demand for VA health services is not as widely studied. Factors such as demographics (Hausmann et al, 2014;Liu, Maciejewski, & Sales, 2005), private health insurance coverage (Shen, Hendricks, Wang, Gardner, & Kazis, 2008), and Medicare eligibility (Carey et al, 2008;Hynes et al, 2007;Liu et al, 2010;Liu et al, 2011) have been examined.…”