Changes in Reproductive and Sexual Health Diagnoses of Women Veterans Using Department of Veterans Affairs Health Care Between FY2010 and FY2018.

BACKGROUND

Women veterans are the fastest growing group of new Veterans Health Administration (VA) users, with more than half a million women veterans using VA care in 2018. VA has implemented policies and programs to meet the reproductive and sexual health (RSH) needs of women veterans who increasingly rely on VA to provide comprehensive care.

OBJECTIVE

We aimed to describe changes in the prevalence of RSH diagnosis categories among women veterans using VA care in fiscal year (FY) 2010 and FY2018.

METHODS

Repeated cross-sectional VA administrative data were used to identify women veterans using VA care in FY2010 and FY2018. RSH diagnosis categories were identified from International Classification of Diseases (ICD), Ninth (FY2010) and 10th (FY2018) revision codes for all VA-covered health care encounters. Standardized incidence ratios (SIRs) were used to adjust for age and compare the rates of 15 reproductive health diagnoses in FY2010 and FY2018.

RESULTS

Women veterans using VA for RSH care increased by 61% between FY2010 (n = 317,122) and FY2018 (n = 520,179). Prevalence of common RSH diagnoses remained consistent across fiscal years, including urinary conditions (SIR = 1.02; 95% CI [1.02, 1.03]) and reproductive organ conditions (SIR = .96; 95% CI [.95, .97]). Conversely, there were larger than expected increases in diagnoses of female infertility (SIR = 1.71; 95% CI [1.70, 1.76]) and sexual dysfunction (SIR = 1.51; 95% CI [1.47, 1.54]).

CONCLUSION

As VA continues to build capacity to provide RSH care to women veterans, understanding changing needs is important for evaluating the impact of programs and policies designed to improve access to care.