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dc.contributor.authorReddy, Shivanien_US
dc.date.accessioned2015-10-05T17:54:39Z
dc.date.available2015-10-05T17:54:39Z
dc.date.issued2015
dc.identifier.urihttps://hdl.handle.net/2144/13279
dc.description.abstractBackground: Increasing numbers of women veterans (WV) present an organizational challenge to a healthcare system that primarily serves men. WV use reproductive services traditionally not provided by the Veterans Health Administration (VHA). Objective: Examine the association of organizational factors and adoption of comprehensive women’s health (WH) care in the VHA. Study Design: Cross-sectional secondary analysis of the 2007 VHA Survey of Women’s Veterans Health Programs and Practices. Methods: Dependent measures were (a) model of women’s health care: separate women’s health clinic (WHC), designated women’s health provider within primary care (DWHP), both (WHC/DWHP), or neither and (b) availability of five basic WH services: cervical cancer screening and evaluation and management of: vaginitis, menstrual disorders, contraception and menopause. Exposure variables were organizational factors drawn from an adaptation of the Greenhalgh model of diffusion of innovations including structural factors, measures of absorptive capacity and system readiness for innovation. Results: Compared to sites with DWHP or neither, WHC and WHC/DWHP were more likely at facilities with: a gynecology clinic, an academic affiliation, a WH representative on high impact committee, and a greater number of WV. Academic affiliation and high impact committee remained significant in multivariable analysis. All five basic WH services were more likely to be offered at sites with WHC or WHC/DWHP, remaining significant after adjusting for organizational factors. Conclusion: Facilities that adopt WHC are associated with greater absorptive capacity (academic affiliation and WH representation on high-impact committees) and are more likely to deliver basic WH services. Separate WHCs may promote more comprehensive care for WV.en_US
dc.language.isoen_US
dc.subjectHealth care managementen_US
dc.subjectOrganizational factorsen_US
dc.subjectReproductive healthen_US
dc.subjectUnited States Department of Veterans Affairsen_US
dc.subjectVeteransen_US
dc.subjectWomen's healthen_US
dc.titleThe role of organizational factors in the provision of comprehensive women's health in the veterans health administrationen_US
dc.typeThesis/Dissertationen_US
dc.date.updated2015-10-03T01:09:51Z
etd.degree.nameMaster of Scienceen_US
etd.degree.levelmastersen_US
etd.degree.disciplineHealth Policy & Managementen_US
etd.degree.grantorBoston Universityen_US


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