Rebecca K Sripada1,2,3,4, Claire M Hannemann4,5, Paula P Schnurr6,7, Brian P Marx8,9,10, Stacey J Pollack5, John F McCarthy1,3,4,5. 1. Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI. 2. Veterans Affairs Ann Arbor Health Care System, Ann Arbor, MI. 3. Department of Psychiatry, University of Michigan, Ann Arbor, MI. 4. Veterans Affairs Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, MI. 5. Office of Mental Health and Suicide Prevention, VA Central Office, Department of Veterans Affairs, Washington, DC. 6. Executive Division, National Center for PTSD, White River Junction, VT. 7. Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH. 8. Behavioral Science Division, National Center for PTSD, Boston, MA. 9. Veterans Affairs Boston Healthcare System, Boston, MA. 10. Department of Psychiatry, School of Medicine, Boston University, Boston, MA.
Abstract
OBJECTIVE: To determine patterns of mental health service use before and after VA disability compensation awards for posttraumatic stress disorder (PTSD). DATA SOURCES: A 10 percent random sample of VHA-enrolled Veterans with new or increased PTSD service connection between 2012 and 2014 (n = 22,249). STUDY DESIGN: We used latent trajectory analysis to identify utilization patterns and multinomial logistic regression to assess associations between Veteran characteristics and trajectory membership. DATA EXTRACTION METHODS: We assessed receipt of VHA mental health encounters in each of the 52 weeks prior to and following PTSD disability rating or rating increase. PRINCIPAL FINDINGS: The best fitting model had five groups: No Use (36.6 percent), Low Use (37.7 percent), Increasing Use (9.4 percent), Decreasing Use (11.2 percent), and High Use (5.1 percent). Adjusting for demographic characteristics and compared with the No Use group, Veterans in the other groups were more likely to reside closer to a VHA facility, receive a higher PTSD disability rating, and screen positive for military sexual trauma. CONCLUSIONS: Service use remained stable (80 percent) or increased (9 percent) for the vast majority of Veterans. Service utilization declined for only 11 percent. Data did not indicate substantial service discontinuation following rating. Low VHA service utilization suggests opportunities to enhance outreach for Veterans with PTSD-related disability benefits. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.
OBJECTIVE: To determine patterns of mental health service use before and after VA disability compensation awards for posttraumatic stress disorder (PTSD). DATA SOURCES: A 10 percent random sample of VHA-enrolled Veterans with new or increased PTSD service connection between 2012 and 2014 (n = 22,249). STUDY DESIGN: We used latent trajectory analysis to identify utilization patterns and multinomial logistic regression to assess associations between Veteran characteristics and trajectory membership. DATA EXTRACTION METHODS: We assessed receipt of VHA mental health encounters in each of the 52 weeks prior to and following PTSD disability rating or rating increase. PRINCIPAL FINDINGS: The best fitting model had five groups: No Use (36.6 percent), Low Use (37.7 percent), Increasing Use (9.4 percent), Decreasing Use (11.2 percent), and High Use (5.1 percent). Adjusting for demographic characteristics and compared with the No Use group, Veterans in the other groups were more likely to reside closer to a VHA facility, receive a higher PTSD disability rating, and screen positive for military sexual trauma. CONCLUSIONS: Service use remained stable (80 percent) or increased (9 percent) for the vast majority of Veterans. Service utilization declined for only 11 percent. Data did not indicate substantial service discontinuation following rating. Low VHA service utilization suggests opportunities to enhance outreach for Veterans with PTSD-related disability benefits. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.
Entities:
Keywords:
Veteran; Veterans Affairs; compensation; posttraumatic stress disorder; service connection
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