Mental Health Diagnoses and Utilization of VA Non-Mental Health Medical Services Among Returning Iraq and Afghanistan Veterans

• Published in: Journal of general internal medicine : JGIM 2010-01, Vol.25 (1), p.18-24
• Main Authors: Cohen, Beth E., Gima, Kris, Bertenthal, Daniel, Kim, Sue, Marmar, Charles R., Seal, Karen H.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Afghan Campaign 2001; Afghanistan; Anxiety disorders. Neuroses; Biological and medical sciences; Female; General aspects; Health services utilization; Humans; Internal Medicine; Iraq; Iraq War, 2003-2011; Male; Medical sciences; Medicine; Medicine & Public Health; Mental Disorders - diagnosis; Mental Disorders - psychology; Mental Disorders - therapy; Mental Health; Mental health care; Middle Aged; Miscellaneous; Original; Original Article; Patient Acceptance of Health Care - psychology; Post traumatic stress disorder; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - psychology; Stress Disorders, Post-Traumatic - therapy; United States - epidemiology; United States Department of Veterans Affairs - utilization; Veterans; Veterans - psychology; Young Adult
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-009-1117-3

BACKGROUND Over 35% of returned Iraq and Afghanistan veterans in VA care have received mental health diagnoses; the most prevalent is post-traumatic stress disorder (PTSD). Little is known about these patients’ use of non-mental health medical services and the impact of mental disorders on utilization. OBJECTIVE To compare utilization across three groups of Iraq and Afghanistan veterans: those without mental disorders, those with mental disorders other than PTSD, and those with PTSD. DESIGN AND PARTICIPANTS National, descriptive study of 249,440 veterans newly utilizing VA healthcare between October 7, 2001 and March 31, 2007, followed until March 31, 2008. MEASUREMENTS We used ICD9-CM diagnostic codes to classify mental health status. We compared utilization of outpatient non-mental health services, primary care, medical subspecialty, ancillary services, laboratory tests/diagnostic procedures, emergency services, and hospitalizations during veterans’ first year in VA care. Results were adjusted for demographics and military service and VA facility characteristics. MAIN RESULTS Veterans with mental disorders had 42–146% greater utilization than those without mental disorders, depending on the service category (all P