Women's Health Care in the Deployed Setting 2013-2020: A Health Services Research Approach

Area of Science:

• Military Medicine
• Women's Health
• Public Health

Background:

• Ensuring timely and quality healthcare for active duty servicewomen in deployed settings is critical, especially with evolving oversight of military medical facilities.
• This study addresses the need to examine the provision and utilization of obstetric and gynecologic (OBGYN) care among women in deployed environments.

Purpose of the Study:

• To analyze the types and utilization rates of gynecological and obstetric care received by servicewomen in deployed settings.
• To investigate how socioeconomic and demographic characteristics influence access to and utilization of OBGYN services.

Main Methods:

• Utilized the Military Health System's Theater Medical Data Store to identify women aged 15-54 receiving care between 2013-2020.
• Conducted descriptive statistics on patient demographics (age, race, rank, branch) and OBGYN services utilized.
• Employed multivariable logistic regressions to assess the odds of OBGYN service utilization based on demographic factors.

Main Results:

• A total of 490,482 women received OBGYN services; the majority were aged 25-34, Junior Enlisted, and from the Navy/Marines.
• Top diagnoses included contraceptive prescriptions, sexually transmitted infection (STI) screening, breast disorders, GYN exams, and menstrual abnormalities.
• Black women demonstrated higher odds than White women for seeking contraceptive prescriptions, STI screenings, breast disorder evaluations, GYN exams, and menstrual abnormality care.

Conclusions:

• Significant disparities in OBGYN care utilization were observed, with senior officers more consistently receiving services.
• Interventions are needed to close care gaps, particularly for preventive services like contraception, GYN exams, and STI screenings.
• Policy implementation for comprehensive contraceptive counseling and standardized pre-deployment/deployment care for women's health is recommended.