Abstract
OBJECTIVE
To evaluate the Veterans Health Administration's traumatic brain injury (TBI) screening program in terms of predictors of screening and positive-screen follow-up.
DESIGN
Retrospective administrative data study. Multiple logistic regression analyses were used to estimate the odds of TBI screening at a given appointment and among those screening positive, follow-up in a TBI/polytrauma specialty clinic.
PARTICIPANTS
A total of 15,973 Iraq and Afghanistan war veterans treated at a Veterans Affairs medical center in the upper Midwest during the first 18 months of the TBI screening program.
RESULTS
Almost 90% of Iraq and Afghanistan veteran patients were offered TBI screening and 17% screened positive. Screening rates increased over time and varied by facility. Appointment type predicted screening with increased likelihood of screening during primary care and TBI/polytrauma clinic appointments. Younger, male, and army veterans without psychiatric diagnoses were more likely to be screened. Fifty-two percent of positive TBI screens had subsequent appointments in a TBI/polytrauma specialty clinic during the study period. Rates of follow-up in the clinic increased over time and varied by facility and patient characteristics.
CONCLUSIONS
Within the upper Midwest, Veterans Health Administration has had greater success implementing TBI screening than ensuring follow-up of positive screens in a specialty clinic. Research is needed on barriers to follow-up of positive screens and the outcomes of TBI screening and subsequent specialty care.
TY - JOUR
T1 - Evaluation of the Veterans Health Administration traumatic brain injury screening program in the upper Midwest.
AU - Sayer,Nina A,
AU - Nelson,Dave,
AU - Nugent,Sean,
PY - 2011/11/19/entrez
PY - 2011/11/19/pubmed
PY - 2012/3/20/medline
SP - 454
EP - 67
JF - The Journal of head trauma rehabilitation
JO - J Head Trauma Rehabil
VL - 26
IS - 6
N2 - OBJECTIVE: To evaluate the Veterans Health Administration's traumatic brain injury (TBI) screening program in terms of predictors of screening and positive-screen follow-up. DESIGN: Retrospective administrative data study. Multiple logistic regression analyses were used to estimate the odds of TBI screening at a given appointment and among those screening positive, follow-up in a TBI/polytrauma specialty clinic. PARTICIPANTS: A total of 15,973 Iraq and Afghanistan war veterans treated at a Veterans Affairs medical center in the upper Midwest during the first 18 months of the TBI screening program. RESULTS: Almost 90% of Iraq and Afghanistan veteran patients were offered TBI screening and 17% screened positive. Screening rates increased over time and varied by facility. Appointment type predicted screening with increased likelihood of screening during primary care and TBI/polytrauma clinic appointments. Younger, male, and army veterans without psychiatric diagnoses were more likely to be screened. Fifty-two percent of positive TBI screens had subsequent appointments in a TBI/polytrauma specialty clinic during the study period. Rates of follow-up in the clinic increased over time and varied by facility and patient characteristics. CONCLUSIONS: Within the upper Midwest, Veterans Health Administration has had greater success implementing TBI screening than ensuring follow-up of positive screens in a specialty clinic. Research is needed on barriers to follow-up of positive screens and the outcomes of TBI screening and subsequent specialty care.
SN - 1550-509X
UR - https://www.unboundmedicine.com/medline/citation/22094545/Evaluation_of_the_Veterans_Health_Administration_traumatic_brain_injury_screening_program_in_the_upper_Midwest_
L2 - https://doi.org/10.1097/HTR.0b013e3181ff393c
DB - PRIME
DP - Unbound Medicine
ER -
