Substance abuse as a predictor of VA medical care utilization among Vietnam veterans.

The primary objective was to determine whether Vietnam veterans who had alcohol or drug use problems prior to, during, or immediately after the war used Veterans Administration (VA) health care services more intensively during the next two decades than Vietnam veterans without these behaviors. The secondary objective was to identify predictors of VA health services utilization among data collected at service discharge. Logistic and ordinary least squares regression were used to model the effect of predisposing, enabling, and need factors on utilization of VA health services (N = 571). Results show that Vietnam veterans who had substance use problems either before or immediately after Vietnam used VA health care services more intensively during the next two decades than Vietnam veterans without these behaviors. Depression and psychiatric care seeking were also important predictors. More research is needed to evaluate the impact of health system characteristics and private sector use on the predictive ability of the models.