Contraceptive care in the VA health care system

Borrero, Sonya; Mor, Maria K.; Zhao, Xinhua; McNeil, Melissa; Ibrahim, Said; Hayes, Patricia

doi:10.1016/j.contraception.2011.10.010

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Volume 85, Issue 6 , Pages 580-588, June 2012

Contraceptive care in the VA health care system☆

Sonya Borrero
- Center for Health Equity, Research, and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA
- Corresponding author. Center for Health Equity, Research, and Promotion, VA Pittsburgh Healthcare System, 7180 Highland Drive (151C-H), Pittsburgh, PA 15206, USA. Tel.: +1 412 954 5200; fax: +1 412 954 5264.
Maria K. Mor
- Center for Health Equity, Research, and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA
Xinhua Zhao
- Center for Health Equity, Research, and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA
Melissa McNeil
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA
Said Ibrahim
- Philadelphia Veteran's Administration Medical Center, Philadelphia, PA 19104, USA
- University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
Patricia Hayes
- U.S. Department of Veterans Affairs, Women Veterans Health Strategic Health Care Group, Office of Public Health and Environmental Hazards, Washington, DC 20420, USA

Received 26 July 2011; received in revised form 17 October 2011; accepted 19 October 2011. published online 16 December 2011.

Abstract

Background

Little is known about contraceptive care within the Veterans Affairs (VA) health care system. This study was conducted to assess the prevalence of documented contraception by race/ethnicity within the VA and to examine the association between receiving primary care in women's health clinics (WHCs) and having a documented contraceptive method.

Study Design

We examined national VA administrative and pharmacy data for 103,950 female veterans aged 18–45 years who made at least one primary care clinic visit in 2008. Multivariable regression models were used to examine the associations between race/ethnicity and receipt of care in a WHC with having a method of contraception while controlling for confounders.

Results

Only 22% of women veterans had a documented method of contraception during 2008. After adjusting for potential confounders, Hispanic and African–American women were significantly less likely to have a method compared to whites [odds ratio (OR): 0.82; 95% confidence interval (CI): 0.76–0.88 and OR: 0.85; 95% CI: 0.81–0.89, respectively]. Women who went to WHCs were significantly more likely to have a method of contraception compared to women who went to traditional primary care clinics (OR: 2.05; 95% CI: 1.97–2.14).

Conclusions

Overall contraceptive prevalence in the VA is low, but receiving care in a WHC is associated with a significantly higher likelihood of having a contraceptive method.

Keywords: VA, Women's health, Contraception, Race/ethnicity