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Does Co-Occurring Traumatic Brain Injury Affect VHA Outpatient Health Service Utilization and Associated Costs Among Veterans With Posttraumatic Stress Disorder? An Examination Based on VHA Administrative Data.
J Head Trauma Rehabil. 2017 Jan/Feb; 32(1):E16-E23.JH

Abstract

OBJECTIVE

To examine whether a traumatic brain injury (TBI) diagnosis was associated with increased outpatient service utilization and associated costs among Iraq and Afghanistan (Operation Enduring Freedom [OEF]/Operation Iraqi Freedom [OIF]/Operation New Dawn [OND]) War veterans with posttraumatic stress disorder (PTSD) who used Veterans Health Affairs (VHA) care in a 1-year period.

SETTING

N/A.

PARTICIPANTS

OEF/OIF/OND veterans with a diagnosis of PTSD and/or TBI who utilized VHA services during fiscal year 2012 (N = 164 644).

DESIGN

Observational study using VHA administrative data.

MAIN MEASURES

Outpatient VHA utilization (total and by category of care) and associated costs (total and by VA Health Economic Resource Center cost category).

RESULTS

Veterans in the comorbid PTSD/TBI group had significantly more total outpatient appointment than veterans with PTSD but no TBI. This pattern held for all categories of care except orthopedics. The comorbid TBI/PTSD group ($5769) incurred greater median outpatient healthcare costs than the PTSD ($3168) or TBI-alone ($2815) group.

CONCLUSIONS

Co-occurring TBI increases the already high level of healthcare utilization by veterans with PTSD, suggesting that OEF/OIF/OND veterans with comorbid PTSD/TBI have complex and wide-ranging healthcare needs.

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Authors+Show Affiliations

Kehle-Forbes SM
Center for Chronic Disease Outcomes Research, Minneapolis VHA Health Care System, Minneapolis, Minnesota (Drs Kehle-Forbes, Taylor, and Sayer and Ms Campbell); Departments of Medicine (Drs Kehle-Forbes, Taylor, and Sayer) and Psychiatry (Dr Sayer), University of Minnesota, Minneapolis; and Physical Medicine & Rehabilitation Service, Washington DC VA Medical Center (Dr Scholten).
Campbell EH
No affiliation info available
Taylor BC
No affiliation info available
Scholten J
No affiliation info available
Sayer N
No affiliation info available

MeSH

AdultAfghan Campaign 2001-Ambulatory CareBrain Injuries, TraumaticComorbidityDatabases, FactualFemaleHealth Care CostsHumansIraq War, 2003-2011MaleMiddle AgedOutpatientsStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransYoung Adult

Pub Type(s)

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

Language

eng

PubMed ID

27022960

Citation

Kehle-Forbes, Shannon M., et al. "Does Co-Occurring Traumatic Brain Injury Affect VHA Outpatient Health Service Utilization and Associated Costs Among Veterans With Posttraumatic Stress Disorder? an Examination Based On VHA Administrative Data." The Journal of Head Trauma Rehabilitation, vol. 32, no. 1, 2017, pp. E16-E23.
Kehle-Forbes SM, Campbell EH, Taylor BC, et al. Does Co-Occurring Traumatic Brain Injury Affect VHA Outpatient Health Service Utilization and Associated Costs Among Veterans With Posttraumatic Stress Disorder? An Examination Based on VHA Administrative Data. J Head Trauma Rehabil. 2017;32(1):E16-E23.
Kehle-Forbes, S. M., Campbell, E. H., Taylor, B. C., Scholten, J., & Sayer, N. (2017). Does Co-Occurring Traumatic Brain Injury Affect VHA Outpatient Health Service Utilization and Associated Costs Among Veterans With Posttraumatic Stress Disorder? An Examination Based on VHA Administrative Data. The Journal of Head Trauma Rehabilitation, 32(1), E16-E23. https://doi.org/10.1097/HTR.0000000000000227
Kehle-Forbes SM, et al. Does Co-Occurring Traumatic Brain Injury Affect VHA Outpatient Health Service Utilization and Associated Costs Among Veterans With Posttraumatic Stress Disorder? an Examination Based On VHA Administrative Data. J Head Trauma Rehabil. 2017 Jan/Feb;32(1):E16-E23. PubMed PMID: 27022960.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does Co-Occurring Traumatic Brain Injury Affect VHA Outpatient Health Service Utilization and Associated Costs Among Veterans With Posttraumatic Stress Disorder? An Examination Based on VHA Administrative Data. AU - Kehle-Forbes,Shannon M, AU - Campbell,Emily Hagel, AU - Taylor,Brent C, AU - Scholten,Joel, AU - Sayer,Nina, PY - 2016/3/30/pubmed PY - 2018/2/24/medline PY - 2016/3/30/entrez SP - E16 EP - E23 JF - The Journal of head trauma rehabilitation JO - J Head Trauma Rehabil VL - 32 IS - 1 N2 - OBJECTIVE: To examine whether a traumatic brain injury (TBI) diagnosis was associated with increased outpatient service utilization and associated costs among Iraq and Afghanistan (Operation Enduring Freedom [OEF]/Operation Iraqi Freedom [OIF]/Operation New Dawn [OND]) War veterans with posttraumatic stress disorder (PTSD) who used Veterans Health Affairs (VHA) care in a 1-year period. SETTING: N/A. PARTICIPANTS: OEF/OIF/OND veterans with a diagnosis of PTSD and/or TBI who utilized VHA services during fiscal year 2012 (N = 164 644). DESIGN: Observational study using VHA administrative data. MAIN MEASURES: Outpatient VHA utilization (total and by category of care) and associated costs (total and by VA Health Economic Resource Center cost category). RESULTS: Veterans in the comorbid PTSD/TBI group had significantly more total outpatient appointment than veterans with PTSD but no TBI. This pattern held for all categories of care except orthopedics. The comorbid TBI/PTSD group ($5769) incurred greater median outpatient healthcare costs than the PTSD ($3168) or TBI-alone ($2815) group. CONCLUSIONS: Co-occurring TBI increases the already high level of healthcare utilization by veterans with PTSD, suggesting that OEF/OIF/OND veterans with comorbid PTSD/TBI have complex and wide-ranging healthcare needs. SN - 1550-509X UR - https://www.unboundmedicine.com/medline/citation/27022960/Does_Co_Occurring_Traumatic_Brain_Injury_Affect_VHA_Outpatient_Health_Service_Utilization_and_Associated_Costs_Among_Veterans_With_Posttraumatic_Stress_Disorder_An_Examination_Based_on_VHA_Administrative_Data_ L2 - https://doi.org/10.1097/HTR.0000000000000227 DB - PRIME DP - Unbound Medicine ER -