A Health Profile of Senior-Aged Women Veterans: A Latent Class Analysis of Condition Clusters

Author:

Gonsoulin Margaret E1,Durazo-Arvizu Ramon A2,Goldstein Karen M34,Cao Guichan12,Zhang Qiuying1,Ramanathan Dharani1,Hynes Denise M156

Affiliation:

1. VA Information Resource Center, Edward Hines Jr. VA Hospital, US Department of Veterans Affairs, Hines, Illinois

2. Public Health Services, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois

3. Durham VA Medical Center, Department of Veterans Affairs, North Carolina

4. Duke University School of Medicine, Division of General Internal Medicine, Durham, North Carolina

5. Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, US Department of Veterans Affairs, Hines, Illinois

6. Department of Medicine, College of Medicine and Department of Health Policy and Administration, School of Public Health, University of Illinois, Chicago

Abstract

Abstract Background and Objectives This study characterizes the multiple morbidities experienced by senior-aged women Veterans so that the Veterans Health Administration (VHA) and other health care systems may be better prepared to meet the health care needs of this growing cohort. Research Design and Methods Using the VHA’s Corporate Data Warehouse, we conducted a retrospective observational study of the 38,597 female veteran patients who were at least 65 years old and received care in the VHA during 2013 and 2014. We use a latent class analysis model to cluster diagnoses associated with inpatient and outpatient events over the years. Results The senior-aged women Veterans are characterized by six major classes of disease clusters. We defined these classes as: Healthy (16.24% of the cohort); Ophthalmological Disorders (13.84%); Musculoskeletal Disorders (14.22%); At Risk for Cardiovascular Disease (37.53%); Diabetic with Comorbidities (9.05%); and Multimorbid (9.12%). The patterns and prevalence of these condition classes vary by race, age, and marital status. Discussion and Implications Each of the six clusters can be used to develop clinical practice guidelines that are appropriate for senior-aged women Veterans. Consistent with past literature, the most common conditions in this cohort are hypertension and hyperlipidemia; together they form the most common class, “At Risk of Cardiovascular Disease (CVD)”. Results also show evidence of race-related disparities, with Blacks being more likely to be in the highest risk classes. Also, members of the cohort who are currently married having improved chances of being in the healthy class. And finally, we see a “healthy survivor” effect with the oldest women in our cohort having low overall rates of disease.

Funder

U.S. Department of Veterans Affairs

Publisher

Oxford University Press (OUP)

Subject

General Earth and Planetary Sciences,General Energy

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