Patient Engagement in VA Health Care: Does Gender Play a Role?

The objectives of this study were to compare gender differences in patient activation (i.e. engagement) among Veteran VA health care users, and determine if high engagement is associated with gender. A mailed national survey with Veterans provided demographics and the main outcome, patient engagement (e.g. Patient Activation Measure (PAM) scores). Administrative databases identified: history of military sexual trauma, illness severity (e.g. Charlson Comorbidity Index scores). Bivariate comparisons were conducted by gender, and multivariate logistic regression examined whether patient engagement was independently associated with being a woman Veteran, when controlling for confounders. Bivariate analyses revealed that women Veterans (vs. male Veterans) Veterans reported higher average levels of engagement (59.72 vs. 56.00, p = 0.0008). Multivariate analyses revealed that women Veterans were 1.5 times more likely than male Veterans to report being most highly engaged in their health/health care (e.g. activation scores classified as PAM level 4) [OR = 1.52, CI95 1.06-2.18, p = 0.0079]. Collectively, results indicate that women Veterans are more engaged in their health/health care than male Veterans are. Improvement efforts should focus on narrowing gender differences in patient engagement in health/health care among Veterans receiving care from the VA.