Preventive health services and access to care for male veterans compared with their spouses

The Veterans Health Administration is exploring ways to reform the current Veterans Affairs (VA) system in accordance with the changing health care environment of managed care. One proposal is for the VA to enlarge its patient base by expanding eligibility to include spouses of veterans. To compare reported preventive health care services received by male veterans and their spouses and to measure whether spouses would choose to receive their medical care through a VA medical center, we randomly selected 230 married male veterans and mailed self-administered questionnaires to be completed by them and their spouses; 170 (74%) eligible subjects completed the questionnaire. The mean age of the veterans and spouses was 73.6 and 67.4 years, respectively. Veterans reported significantly higher rates of receipt of recommended preventive services than their spouses in all 5 areas assessed, including blood pressure measurement; influenza, pneumococcal, and tetanus vaccinations; and serum cholesterol measurement. Veterans were significantly more satisfied than their spouses with their current health care. Finally, 83% (95% confidence interval, 77% to 89%) of spouses reported that they would choose to receive their medical care at the VA medical center if allowed to do so. These findings suggest that spouses of male veterans represent a sizable group that could be incorporated into the VA system, especially given their strong desire to do so.