Citation

Maguen S, Madden E, Lau KM, Seal KH. J. Neurotrauma 2013; 30(13): 1123-1128.

Affiliation

San Francisco VA Medical Center, San Francisco, United States; Shira.Maguen@va.gov.

Copyright

(Copyright © 2013, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2012.2744

PMID

23327186

Abstract

We compared mental health outpatient, primary care, and emergency care service utilization among veterans screening TBI-positive (S-TBI+) versus those screening TBI-negative (S-TBI-) and described associations between TBI-related symptoms and health service utilization. Our study population consisted of 1,746 Iraq and Afghanistan veterans in VA care screened for TBI between April 1, 2007 and June 1, 2010. Rates of mental health outpatient, primary care and emergency services utilization were greater for S-TBI+ veterans compared with S-TBI- veterans, even after adjusting for mental health screen results. Irritability on the initial TBI screen was associated with increased mental health outpatient utilization rates (IRR = 1.64, 95 % CI= 1.18-2.3, p<0.01). Reports of dizziness (IRR = 1.24, 95 % CI = 1.02-1.51, p <0.05) and headaches (IRR = 1.41, 95% CI = 1.16-1.7, p < 0.001) were associated with increased primary care utilization rates. Higher utilization rates among veterans who screened positive for TBI were not better explained by screening positive for comorbid mental health problems. Knowing that certain symptoms are more strongly associated with increased utilization in certain health service domains will help to better plan for the care of returning veterans who screen positive for TBI.

Language: en