Tags

Type your tag names separated by a space and hit enter

Prevalence and costs of co-occurring traumatic brain injury with and without psychiatric disturbance and pain among Afghanistan and Iraq War Veteran V.A. users.
Med Care. 2012 Apr; 50(4):342-6.MC

Abstract

BACKGROUND

Traumatic brain injury (TBI) is the "signature injury" in the Afghanistan and Iraq wars [Operation Enduring Freedom in Afghanistan (OEF)/Operation Iraqi Freedom (OIF)]. Patients with combat-related TBI also have high rates of psychiatric disturbances and pain.

OBJECTIVES

To determine the prevalence of TBI alone and TBI with other conditions and the average cost of medical care for veterans with these diagnoses.

METHODS

Observational study using national inpatient, outpatient, and pharmacy data from Veterans Health Administration (VHA) datasets. Costs are estimated from utilization related to care within the VHA system. Participants were all OEF/OIF VHA users in 2009.

RESULTS

Among 327,388 OEF/OIF veterans using VHA services in 2009, 6.7% were diagnosed with TBI. Among those with TBI diagnoses, 89% were diagnosed with a psychiatric diagnosis [the most frequent being posttraumatic stress disorder (PTSD) at 73%], and 70% had a diagnosis of head, back, or neck pain. The rate of comorbid PTSD and pain among those with and without TBI was 54% and 11%, respectively. The median annual cost per patient was nearly 4-times higher for TBI-diagnosed veterans as compared with those without TBI ($5831 vs. $1547). Within the TBI group, cost increased as diagnostic complexity increased, such that those with TBI, pain, and PTSD demonstrated the highest median cost per patient ($7974).

CONCLUSIONS

The vast majority of VHA patients diagnosed with TBI also have a diagnosed mental disorder and more than half have both PTSD and pain. Patients with these comorbidities incur substantial medical costs and represent a target population for future research aimed at improving health care efficiency.

Authors+Show Affiliations

Center for Chronic Disease Outcomes Research, Department of Veterans Affairs Health Care System, Minneapolis, MN 55417, USA. Brent.Taylor2@va.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

22228249

Citation

Taylor, Brent C., et al. "Prevalence and Costs of Co-occurring Traumatic Brain Injury With and Without Psychiatric Disturbance and Pain Among Afghanistan and Iraq War Veteran V.A. Users." Medical Care, vol. 50, no. 4, 2012, pp. 342-6.
Taylor BC, Hagel EM, Carlson KF, et al. Prevalence and costs of co-occurring traumatic brain injury with and without psychiatric disturbance and pain among Afghanistan and Iraq War Veteran V.A. users. Med Care. 2012;50(4):342-6.
Taylor, B. C., Hagel, E. M., Carlson, K. F., Cifu, D. X., Cutting, A., Bidelspach, D. E., & Sayer, N. A. (2012). Prevalence and costs of co-occurring traumatic brain injury with and without psychiatric disturbance and pain among Afghanistan and Iraq War Veteran V.A. users. Medical Care, 50(4), 342-6. https://doi.org/10.1097/MLR.0b013e318245a558
Taylor BC, et al. Prevalence and Costs of Co-occurring Traumatic Brain Injury With and Without Psychiatric Disturbance and Pain Among Afghanistan and Iraq War Veteran V.A. Users. Med Care. 2012;50(4):342-6. PubMed PMID: 22228249.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and costs of co-occurring traumatic brain injury with and without psychiatric disturbance and pain among Afghanistan and Iraq War Veteran V.A. users. AU - Taylor,Brent C, AU - Hagel,Emily M, AU - Carlson,Kathleen F, AU - Cifu,David X, AU - Cutting,Andrea, AU - Bidelspach,Douglas E, AU - Sayer,Nina A, PY - 2012/1/10/entrez PY - 2012/1/10/pubmed PY - 2012/4/28/medline SP - 342 EP - 6 JF - Medical care JO - Med Care VL - 50 IS - 4 N2 - BACKGROUND: Traumatic brain injury (TBI) is the "signature injury" in the Afghanistan and Iraq wars [Operation Enduring Freedom in Afghanistan (OEF)/Operation Iraqi Freedom (OIF)]. Patients with combat-related TBI also have high rates of psychiatric disturbances and pain. OBJECTIVES: To determine the prevalence of TBI alone and TBI with other conditions and the average cost of medical care for veterans with these diagnoses. METHODS: Observational study using national inpatient, outpatient, and pharmacy data from Veterans Health Administration (VHA) datasets. Costs are estimated from utilization related to care within the VHA system. Participants were all OEF/OIF VHA users in 2009. RESULTS: Among 327,388 OEF/OIF veterans using VHA services in 2009, 6.7% were diagnosed with TBI. Among those with TBI diagnoses, 89% were diagnosed with a psychiatric diagnosis [the most frequent being posttraumatic stress disorder (PTSD) at 73%], and 70% had a diagnosis of head, back, or neck pain. The rate of comorbid PTSD and pain among those with and without TBI was 54% and 11%, respectively. The median annual cost per patient was nearly 4-times higher for TBI-diagnosed veterans as compared with those without TBI ($5831 vs. $1547). Within the TBI group, cost increased as diagnostic complexity increased, such that those with TBI, pain, and PTSD demonstrated the highest median cost per patient ($7974). CONCLUSIONS: The vast majority of VHA patients diagnosed with TBI also have a diagnosed mental disorder and more than half have both PTSD and pain. Patients with these comorbidities incur substantial medical costs and represent a target population for future research aimed at improving health care efficiency. SN - 1537-1948 UR - https://www.unboundmedicine.com/medline/citation/22228249/Prevalence_and_costs_of_co_occurring_traumatic_brain_injury_with_and_without_psychiatric_disturbance_and_pain_among_Afghanistan_and_Iraq_War_Veteran_V_A__users_ L2 - https://doi.org/10.1097/MLR.0b013e318245a558 DB - PRIME DP - Unbound Medicine ER -