Women Veterans Receive 60% of Emergency Department Care at VA Sites

Researchers examined VA administrative and community emergency care claims data for a retrospective cohort of 1.6 million VA-enrolled Veterans with at least one emergency department (ED) visit between October 2022 and September 2023. The study compared utilization by sex and used adjusted logistic regression with generalized estimating equations to identify factors associated with women receiving care at VA rather than VA Community Care EDs.

Among women, 60% of ED visits occurred at VA sites. Low-acuity visits were associated with higher odds of VA ED use (OR 1.62, 95% CI 1.59–1.64), as were behavioral health visits (OR 1.10, 95% CI 1.06–1.14). VA ED use was less likely among women experiencing homelessness (OR 0.90, 95% CI 0.86–0.93) and for emergency care-sensitive conditions, such as myocardial infarction or stroke (OR 0.61, 95% CI 0.60–0.63).

Racially and ethnically minoritized women had greater odds of VA ED use than White women, while greater distance from VA EDs was associated with lower use. The findings support service planning and coordination across VA and community settings. However, this observational analysis identifies associations rather than causes and covers VA enrollees with documented VA or Community Care visits, not all women Veterans. Diagnosis-based visit classifications and administrative data also warrant caution when interpreting care needs.