Medical Service Utilization by Veterans Seeking Help for Posttraumatic Stress Disorder

Patrick S. Calhoun · Hayden Barry Bosworth · Steven C. Grambow · Tara K. Dudley · Jean C. Beckham

145 citations0/0 files storedAmerican Journal of Psychiatry

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Posttraumatic Stress Disorder Research Traumatic Brain Injury Research Migration, Health and Trauma

Abstract

OBJECTIVE: Posttraumatic stress disorder (PTSD) has been associated with higher rates of health complaints and medical conditions diagnosed by physicians, yet research examining the relationship between PTSD and health care utilization has been limited. This study compared the health service use of veterans with PTSD to that of help-seeking veterans without PTSD. The relationship between severity of PTSD and service utilization was also examined. METHOD: Data were collected from 996 veterans seeking an evaluation at a Veterans Affairs (VA) Medical Center specialty PTSD clinic in the southeastern United States between March 1992 and September 1998. Data included sociodemographic characteristics, severity of PTSD, and disability status. The outcome variable, VA health service utilization, was prospectively assessed 1 year from the date of the initial PTSD assessment. RESULTS: Although the use of VA mental health services by patients with PTSD was substantial (a median of seven clinic stops), these patients used more services in general physical health clinics that provided predominantly nonmental health services (a median of 18 clinic stops). Negative binomial regression models revealed that younger veterans with PTSD had greater health care utilization than those without PTSD who also sought services. Greater severity of PTSD was related to higher rates of mental and physical health service use among veterans without a service-connected disability. CONCLUSIONS: PTSD is associated with substantial health service use. The results highlight the importance of increased collaboration between primary care and mental health specialists, given that patients with PTSD are more likely to receive treatment in nonmental health clinics.

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References

1995Posttraumatic Stress Disorder in the National Comorbidity Survey 1995The development of a Clinician-Administered PTSD Scale 1990Trauma and the Vietnam War generation: report of findings from the National Vietnam Veterans Readjustment Study 1988Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: Three studies in reliability and validity.1989Clinical evaluation of a measure to assess combat exposure.1992Service Utilization and Social Morbidity Associated With Depressive Symptoms in the Community 1999Past-Year Use of Outpatient Services for Psychiatric Problems in the National Comorbidity Survey 1996Comparison of self-reported and medical record health care utilization measures

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2009The Link Between Post-traumatic Stress Disorder and Physical Comorbidities: A Systematic Review 2005Health service use predictors among trauma survivors: A critical review.2010The impact of PTSD, depression, and substance use disorders on disease burden and health care utilization among OEF/OIF veterans.2012Health service utilization before and after evidence-based treatment for PTSD.

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