Citation

Taylor B, Hagel Campbell E, Nugent S, Bidelspach D, Kehle-Forbes S, Scholten J, Stroupe K, Sayer N. J. Neurotrauma 2017; 34(17): 2567-2574.

Affiliation

University of Minnesota Twin Cities, 5635, Department of Psychiatry, Minneapolis, Minnesota, United States ; nina.sayer@va.gov.

Copyright

(Copyright © 2017, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2016.4910

PMID

28482747

Abstract

Examination of trends in Veterans Health Administration (VHA) healthcare utilization and costs among veterans with mild Traumatic Brain Injury (TBI) is needed to inform policy, resource allocation and treatment planning. The objective of this study was to assess the patterns of VHA healthcare utilization and costs in the three years following TBI screening among veterans with mild TBI compared with veterans without TBI. A retrospective cohort study of veterans who underwent TBI screening in fiscal year 2010 was conducted. We used VHA healthcare utilization and associated costs by categories of care to compare veterans diagnosed with mild TBI (n=7,318) to those who screened negative (n=75,294) and those who screened positive but had TBI ruled out (n=3,324). Utilization and costs were greatest in year one, dropped in year two and then leveled off. Mild TBI diagnosis was associated with high rates of utilization. Each year, healthcare costs in those with mild TBI were 2 to 3 times higher than in those who screened negative and 20 to 25% higher than in those who screened positive but had TBI ruled out. A significant proportion of healthcare use and costs for veterans with mild TBI were associated with mental health service utilization. The relatively high rate of VHA utilization and costs associated with mild TBI over time demonstrates the importance of long-term planning to meet these veterans' needs. Identifying and engaging patients with mTBI in effective mental health treatments should be considered a critical component of treatment planning.

Language: en

Keywords

EPIDEMIOLOGY; HUMAN STUDIES; PROSPECTIVE STUDY; REHABILITATION; TRAUMATIC BRAIN INJURY