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Health Services Utilization, Health Care Costs, and Diagnoses by Mild Traumatic Brain Injury Exposure: A Chronic Effects of Neurotrauma Consortium Study.
- Source :
-
Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2020 Oct; Vol. 101 (10), pp. 1720-1730. Date of Electronic Publication: 2020 Jul 10. - Publication Year :
- 2020
-
Abstract
- Objective: To compare Veterans Health Administration (VHA) diagnoses, health services utilization, and costs by mild traumatic brain injury (mTBI) group (blast-related [BR] mTBI vs non-blast-related [NBR] mTBI vs no mTBI) among Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) veterans in the Chronic Effects of Neurotrauma Consortium multicenter observational study.<br />Design: Prospective cohort study.<br />Setting: Four Veterans Affairs Medical Centers.<br />Participants: OEF/OIF/OND veterans (N=472) who used Veterans Affairs Medical Centers services between 2002-2017.<br />Interventions: Not applicable. Lifetime mTBI history was assessed via semistructured interviews.<br />Main Outcome Measures: VHA diagnoses, health services utilization, and costs.<br />Results: Relative to NBR mTBI and no mTBI, veterans with BR mTBI were more likely to be male, have greater combat, and have controlled and uncontrolled detonations exposures (median BR, 15.0 vs NBR, 3.0 vs no mTBI, 3.0). They also had higher prevalence of headache, posttraumatic stress disorder, and anxiety diagnoses. Veterans with BR had the highest site-adjusted mean annual VHA utilization (26.31 visits; 95% confidence interval [CI], 26.01-26.61) relative to NBR (20.43 visits; 95% CI, 20.15-20.71) and no mTBI (16.62 visits; 95% CI, 16.21-17.04) and highest site adjusted mean annual VHA outpatient costs ($6480; 95% CI, $5842-$7187) relative to NBR ($4901; 95% CI, $4392-$5468) and no mTBI ($4069; 95% CI, $3404-$4864).<br />Conclusions: Veterans with BR mTBI had higher exposure to combat and detonation. BR was associated with greater prevalence of select diagnoses and higher health services utilization and costs relative to NBR and no mTBI. The role of health care needs from mTBI polytrauma, other deployment-related exposures, and VHA access warrants future research.<br /> (Published by Elsevier Inc.)
- Subjects :
- Adolescent
Adult
Brain Concussion economics
Chronic Disease
Female
Health Services economics
Health Services statistics & numerical data
Health Status
Humans
Iraq War, 2003-2011
Male
Mental Health
Military Personnel psychology
Military Personnel statistics & numerical data
Prospective Studies
Sex Factors
Socioeconomic Factors
Trauma Severity Indices
United States
Veterans psychology
Veterans Health Services statistics & numerical data
Young Adult
Brain Concussion epidemiology
Health Expenditures statistics & numerical data
Patient Acceptance of Health Care statistics & numerical data
Stress Disorders, Post-Traumatic epidemiology
Veterans statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1532-821X
- Volume :
- 101
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Archives of physical medicine and rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 32653582
- Full Text :
- https://doi.org/10.1016/j.apmr.2020.06.008