PORTLAND – More than a thousand new combat veterans have streamed into the federal Veterans Affairs health care system in Maine since the U.S. went to war in Afghanistan and Iraq more than five years ago.

The new veterans are entering the VA system at the same time as aging war veterans who served in Vietnam and Korea, sending enrollment in Maine to its highest level ever.

About 38,000 veterans are actively using the system in Maine, more than double the number in 1998 and an all-time high since the Togus VA Medical Center admitted its first veteran in 1866, the Maine Sunday Telegram reported.

It’s numbers like those that are raising questions about whether the VA is equipped to handle the strain.

“We’re concerned the system is going to be completely overwhelmed,” said David Autry, a spokesman for the Disabled American Veterans in Washington, D.C.

Maine has more than 154,000 veterans, which is nearly 16 percent of the civilian population over age 18 and the fifth-highest percentage of veterans in the country, according to the U.S. Census Bureau.

About one in four receives health care from the VA, which has 67 beds at its 500-acre Togus complex outside of Augusta, plus outpatient clinics in Bangor, Calais, Caribou, Rumford, Saco and Lincoln. System officials say they expect enrollment in Maine to grow by about 10 percent over the next five years.

In some regards, the Veterans Affairs health care system in Maine appears to work better than it does nationwide.

The most recent customer service survey conducted by the VA shows that patient satisfaction at Togus is above the national average. A majority of 32 Maine veterans interviewed by the Maine Sunday Telegram said they were generally pleased with the health care they receive from the VA.

But others had issues ranging from long waits for appointments and problems reaching VA staffers by telephone to budgetary needs and staffing levels.

James Bachelder, a disabled veteran from Acton, said he was once driving to Togus when he called the hospital on his cell phone, only to discover that his doctor’s appointment had been canceled. It took another couple of months before he got in to see his doctor, he said.

“They don’t have enough staff, so if an emergency comes up and calls away the doctor, then everybody scheduled for an appointment doesn’t have one,” Bachelder said.

Some older veterans in Maine complain that Togus is already overtaxed and does not have enough clinicians to accommodate the 38,000 veterans actively using the system.

“If they can’t treat us old vets right, how are they going to treat the new ones?” asked Donald Staples, a 59-year-old Vietnam War veteran from Windham. He said he is frustrated because he has to go outside the VA system for X-rays and CT scans because the Saco clinic he visits does not have the necessary equipment.

VA officials say Maine veterans five years ago could expect to wait up to a year to get their first appointment with a VA doctor. The backlog followed a decision during the 1990s to expand eligibility for VA health care.

In 2003, eligibility was tightened again, and Veterans Affairs officials in Maine say they have made progress in reducing wait times.

“Our goal is less than 30 days,” said Jack Sims, the former director of Togus who retired last month. “Do we hit that all the time? No, however, we’re trying hard.”