A national survey of women veterans points to a greater need for access to community-based medical care and a need to integrate traditional veterans services with primary care, reproductive care and mental health care.

The number of women veterans who use the Veterans Health Administration (VA) has doubled over the past decade, signaling the importance of a better understanding of their health care needs.

The study, recently published in the Journal of General Internal Medicine, surveyed 3,611 women veterans from 2008 to 2009. While prior research looked at gender differences in what veterans prefer in health services, little has been done on the differences between women veterans of various service eras.

The study found that women veterans from Operation Enduring Freedom (Afghanistan), Operation Iraqi Freedom and Operation New Dawn (Iraq) had the highest use of mental health care, and the highest VA utilization rates. They, along with first Gulf War-era women veterans, had the highest use of women's health services, including reproductive health care. World War II and Korean War-era women veterans had the highest use of specialty care.

Women vets from the Gulf War, Iraq and Afghanistan made more visits for VA care than women vets from earlier eras. That may suggest a significant shift in how the VA, which has long battled the perception of being unfriendly to women, is regarded by newer women vets.

The survey found the greatest health care concern for Vietnam and earlier women vets was the convenience of VA locations; for first Gulf War and Iraq and Afghanistan era women vets, the main concern was cost. Resources that offer gynecological services also were rated as important by women vets of all eras.

"VA community-based outpatient clinics are an important, often conveniently located resource for women veterans, so policymakers may wish to increase the funding and resources available to these clinics," the study recommends.

Mark Brunswick • 612-673-4434