Associations Between Health-Related Quality of Life and Financial Barriers to Care Among Women Veterans and Women Non-Veterans

Abstract

The authors of this study examined the association between health-related quality of life and financial barriers to care, defined as not getting the needed care due to cost considerations. To better understand health-related quality of life among women veterans, the authors compared women veterans to women non-veterans. The authors conducted cross-sectional analyses using data from the 2009 Behavioral Risk Factor Surveillance System survey. The authors assessed four health-related quality of life measures: (1) general health; (2) physical health; (3) mental health; and (4) functional status. The authors performed multinomial logistic regressions to examine the relationship between financial barriers to receiving healthcare and health-related quality of life measures after controlling for other independent variables. The authors included women veterans not in active military duty (N = 3,747) and a matched sample of women non-veterans (N = 3,747), selected using a propensity score method so that they would have distributions of demographic and socioeconomic characteristics similar to those of the veterans. Overall, 14% of women reported financial barriers. Women who reported financial barriers to receiving healthcare were more likely to have poor health-related quality of life in all four dimensions than those who did not report such barriers. Compared to women non-veterans, women veterans did not differ in reported financial barriers but were more likely to report poor health-related quality of life. Reporting financial barriers to receiving needed healthcare was significantly associated with poor health-related quality of life among women. Veteran status was also significantly associated with poor health-related quality of life. These findings suggest the need for healthcare policy makers and practitioners to align emerging new models of healthcare delivery to improve health-related quality of life for women veterans.

KEYWORDS:

• quality of life
• socioeconomic status
• psychosocial

Notes

Dr. Sambamoorthi was partially supported with infrastructure by the Collaborative Health Outcomes Research of Therapies and Services (CoHORTS) Grant (1 P20 HS 015390-02). The findings and opinions reported here are those of the authors and do not necessarily represent the views of any organizations.

**0.001 ≤ p < 0.05.

***p < .001

Superscripts a, b, and c represent significant differences (p < .001) in health-related quality of life measures by presence and absence of financial barrier to healthcare based on chi-square tests for three different samples: (a) combined women veterans and women non-veterans

(b) women veterans

and (c) women non-veterans.