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Comparing Outcomes of the Veterans Health Administration's Traumatic Brain Injury and Mental Health Screening Programs: Types and Frequency of Specialty Services Used.
Miles, Shannon R; Sayer, Nina A; Belanger, Heather G; Venkatachalam, Hari H; Kozel, Frank Andrew; Toyinbo, Peter A; McCart, James A; Luther, Stephen L.
Afiliación
  • Miles SR; Mental Health and Behavioral Sciences, James A. Haley Veterans' Hospital, Tampa, Florida, USA.
  • Sayer NA; Department of Psychiatry & Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
  • Belanger HG; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA.
  • Venkatachalam HH; Departments of Medicine and Psychiatry, University of Minnesota, Minneapolis, USA.
  • Kozel FA; Department of Psychology, University of South Florida, Tampa, Florida, USA.
  • Toyinbo PA; United States Special Operations Command, St. Michael's Inc.
  • McCart JA; Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida, USA.
  • Luther SL; Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida, USA.
J Neurotrauma ; 40(1-2): 102-111, 2023 01.
Article en En | MEDLINE | ID: mdl-35898115
The Veterans Health Administration (VHA) screens veterans who deployed in support of the wars in Afghanistan and Iraq for traumatic brain injury (TBI) and mental health (MH) disorders. Chronic symptoms after mild TBI overlap with MH symptoms, for which there are already established screens within the VHA. It is unclear whether the TBI screen facilitates treatment for appropriate specialty care over and beyond the MH screens. Our primary objective was to determine whether TBI screening is associated with different types (MH, Physical Medicine & Rehabilitation [PM&R], and Neurology) and frequency of specialty services compared with the MH screens. A retrospective cohort design examined veterans receiving VHA care who were screened for both TBI and MH disorders between Fiscal Year (FY) 2007 and FY 2018 (N = 241,136). We calculated service utilization counts in MH, PM&R, and Neurology in the six months after the screens. Zero-inflated negative binomial regression models of encounters (counts) were fit separately by specialty care type and for a total count of specialty services. We found that screening positive for TBI resulted in 2.38 times more specialty service encounters than screening negative for TBI. Compared with screening positive for MH only, screening positive for both MH and TBI resulted in 1.78 times more specialty service encounters and 1.33 times more MH encounters. The TBI screen appears to increase use of MH, PM&R, and Neurology services for veterans with post-deployment health concerns, even in those also identified as having a possible MH disorder.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos por Estrés Postraumático / Veteranos / Lesiones Traumáticas del Encéfalo Tipo de estudio: Diagnostic_studies / Screening_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: J Neurotrauma Asunto de la revista: NEUROLOGIA / TRAUMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos por Estrés Postraumático / Veteranos / Lesiones Traumáticas del Encéfalo Tipo de estudio: Diagnostic_studies / Screening_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: J Neurotrauma Asunto de la revista: NEUROLOGIA / TRAUMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos