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Diffusion of innovation in women's health care delivery: the Department of Veterans Affairs' adoption of women's health clinics.
Womens Health Issues. 2006 Sep-Oct; 16(5):226-35.WH

Abstract

BACKGROUND

In response to concerns about the availability and quality of women's health services in Department of Veterans Affairs (VA) medical centers in the early 1990s, Congress approved landmark legislation earmarking funds to enhance women's health services. A portion of the appropriation was used to launch Comprehensive Women's Health Centers as exemplars for the development of VA women's health care throughout the system. We report on the diffusion and characteristics of VA women's health clinics (WHCs) 10 years later.

METHODS

In 2001, we surveyed the senior women's health clinician at each VA medical center serving > or =400 women veterans (83% response rate) regarding their internal organizational characteristics in relation to factors associated with organizational innovation (centralization, complexity, formalization, interconnectedness, organizational slack, size). We evaluated the comparability of WHCs (n = 66) with characteristics of the original comprehensive women's health centers (CWHCs; n = 8).

RESULTS

Gender-specific service availability in WHCs was comparable to that of CWHCs with important exceptions in mental health, mammography and osteoporosis management. WHCs were less likely to have same-gender providers (p < .05), women's health training programs (p < .01), separate women's mental health clinics (p < .001), separate space (p < .05), or adequate privacy (p < .05); however, they were less likely to have experienced educational program closures (p < .001) and staffing losses (p < .05) compared to CWHCs.

CONCLUSIONS

Diffusion of comprehensive women's health care is as yet incomplete. More research is needed to examine the quality of care associated with these models and to establish the business case for managers faced with small female patient caseloads.

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Authors+Show Affiliations

Yano EM
VA Greater Los Angeles Health Services Research and Development (HSR&D) Center of Excellence, 16111 Plummer Street (152), Sepulveda, CA 91343, USA. elizabeth.yano@va.gov
Goldzweig C
No affiliation info available
Canelo I
No affiliation info available
Washington DL
No affiliation info available

MeSH

Diffusion of InnovationFemaleHealth Care SurveysHealth Services AccessibilityHospitals, VeteransHumansQuality of Health CareUnited StatesUnited States Department of Veterans AffairsVeteransWomen's HealthWomen's Health Services

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17055375

Citation

Yano, Elizabeth M., et al. "Diffusion of Innovation in Women's Health Care Delivery: the Department of Veterans Affairs' Adoption of Women's Health Clinics." Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, vol. 16, no. 5, 2006, pp. 226-35.
Yano EM, Goldzweig C, Canelo I, et al. Diffusion of innovation in women's health care delivery: the Department of Veterans Affairs' adoption of women's health clinics. Womens Health Issues. 2006;16(5):226-35.
Yano, E. M., Goldzweig, C., Canelo, I., & Washington, D. L. (2006). Diffusion of innovation in women's health care delivery: the Department of Veterans Affairs' adoption of women's health clinics. Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, 16(5), 226-35.
Yano EM, et al. Diffusion of Innovation in Women's Health Care Delivery: the Department of Veterans Affairs' Adoption of Women's Health Clinics. Womens Health Issues. 2006 Sep-Oct;16(5):226-35. PubMed PMID: 17055375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diffusion of innovation in women's health care delivery: the Department of Veterans Affairs' adoption of women's health clinics. AU - Yano,Elizabeth M, AU - Goldzweig,Caroline, AU - Canelo,Ismelda, AU - Washington,Donna L, PY - 2005/10/28/received PY - 2006/07/21/revised PY - 2006/07/24/accepted PY - 2006/10/24/pubmed PY - 2007/1/24/medline PY - 2006/10/24/entrez SP - 226 EP - 35 JF - Women's health issues : official publication of the Jacobs Institute of Women's Health JO - Womens Health Issues VL - 16 IS - 5 N2 - BACKGROUND: In response to concerns about the availability and quality of women's health services in Department of Veterans Affairs (VA) medical centers in the early 1990s, Congress approved landmark legislation earmarking funds to enhance women's health services. A portion of the appropriation was used to launch Comprehensive Women's Health Centers as exemplars for the development of VA women's health care throughout the system. We report on the diffusion and characteristics of VA women's health clinics (WHCs) 10 years later. METHODS: In 2001, we surveyed the senior women's health clinician at each VA medical center serving > or =400 women veterans (83% response rate) regarding their internal organizational characteristics in relation to factors associated with organizational innovation (centralization, complexity, formalization, interconnectedness, organizational slack, size). We evaluated the comparability of WHCs (n = 66) with characteristics of the original comprehensive women's health centers (CWHCs; n = 8). RESULTS: Gender-specific service availability in WHCs was comparable to that of CWHCs with important exceptions in mental health, mammography and osteoporosis management. WHCs were less likely to have same-gender providers (p < .05), women's health training programs (p < .01), separate women's mental health clinics (p < .001), separate space (p < .05), or adequate privacy (p < .05); however, they were less likely to have experienced educational program closures (p < .001) and staffing losses (p < .05) compared to CWHCs. CONCLUSIONS: Diffusion of comprehensive women's health care is as yet incomplete. More research is needed to examine the quality of care associated with these models and to establish the business case for managers faced with small female patient caseloads. SN - 1049-3867 UR - https://www.unboundmedicine.com/medline/citation/17055375/Diffusion_of_innovation_in_women's_health_care_delivery:_the_Department_of_Veterans_Affairs'_adoption_of_women's_health_clinics_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1049-3867(06)00087-9 DB - PRIME DP - Unbound Medicine ER -