Robert Rosenheck1, Alan Fontana. 1. Department of Veterans Affairs Northeast Program Evaluation Center, West Haven, Connecticut 06516, USA.
Abstract
OBJECTIVES: This study examines differences in treatment process and outcomes among minority veterans treated in specialized intensive VA programs for war-related Posttraumatic Stress Disorder (PTSD). DESIGN: A concurrent panel study assessing four different types of intensive PTSD treatment program. SUBJECTS: Black (n = 2,906; 23.4%), Hispanic (n = 661, 5.3%), and white veterans. METHODS: Hierarchical linear modeling was used to compare black and Hispanic veterans with white veterans on admission characteristics, treatment process, and outcomes, overall, and to determine whether treatment in three newer types of programs, each designed to improve efficiency, was associated with in changes in minority group experiences. RESULTS: At the time of program admission, black patients had less education, were less likely to be married or to receive VA compensation, and had more severe alcohol and drug problems, but had less severe PTSD symptoms than either white patients or Hispanic patients. There were no differences among groups on 8 of 11 measures of treatment process or outcome but black patients showed greater improvement than white patients on one measure of PTSD symptoms and Hispanic patients were more satisfied with their treatment than white patients although they showed smaller gains in employment income. There were few changes associated with newer program types: gains for minorities were observed on three measures and losses on two. CONCLUSIONS: Using data from a large national sample, this study found little evidence of systematic differences in either treatment process or outcome between white, black, and Hispanic patients overall, or in association with the implementation of more efficient program types.
OBJECTIVES: This study examines differences in treatment process and outcomes among minority veterans treated in specialized intensive VA programs for war-related Posttraumatic Stress Disorder (PTSD). DESIGN: A concurrent panel study assessing four different types of intensive PTSD treatment program. SUBJECTS: Black (n = 2,906; 23.4%), Hispanic (n = 661, 5.3%), and white veterans. METHODS: Hierarchical linear modeling was used to compare black and Hispanic veterans with white veterans on admission characteristics, treatment process, and outcomes, overall, and to determine whether treatment in three newer types of programs, each designed to improve efficiency, was associated with in changes in minority group experiences. RESULTS: At the time of program admission, black patients had less education, were less likely to be married or to receive VA compensation, and had more severe alcohol and drug problems, but had less severe PTSD symptoms than either white patients or Hispanic patients. There were no differences among groups on 8 of 11 measures of treatment process or outcome but black patients showed greater improvement than white patients on one measure of PTSD symptoms and Hispanic patients were more satisfied with their treatment than white patients although they showed smaller gains in employment income. There were few changes associated with newer program types: gains for minorities were observed on three measures and losses on two. CONCLUSIONS: Using data from a large national sample, this study found little evidence of systematic differences in either treatment process or outcome between white, black, and Hispanic patients overall, or in association with the implementation of more efficient program types.