Racial disparities in VA service connection for posttraumatic stress disorder disability
Racial disparities in VA service connection for posttraumatic stress disorder disability
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DOI：
10.1097/00005650-200304000-00009
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发表时间：
2003-04-01
期刊：
影响因子：
3
通讯作者：
van Ryn, M
中科院分区：
文献类型：
--
作者：
Murdoch, M;Hodges, J;van Ryn, M
背景。 “服役相关”退伍军人是指那些有记录的、与服兵役相关或因服兵役而加重病情的退伍军人，他们可以优先加入退伍军人事务部 (VA) 医疗保健系统。对于一些退伍军人来说，服务连接代表了使用 VA 医疗保健设施和无法使用之间的区别。 目标。确定退伍军人事务部在授予创伤后应激障碍 (PTSD) 服务联系方面是否存在种族差异，如果存在，则确定这些差异是否可归因于适当的受试者特征，例如 PTSD 症状严重程度或功能状态的差异。研究设计。与行政数据相关的邮寄调查。对 11% 的样本进行了索赔审计。 设置和主题。该研究从 1994 年 1 月 1 日至 1998 年 12 月 31 日期间提交 PTSD 残疾索赔的所有退伍军人中随机抽取了 2700 名男性和 2700 名女性。 结果。共有 3337 名退伍军人返回了可用的调查，其中 17% 是黑人。只有 16% 的受访者拥有私人健康保险，44% 的受访者报告收入为 20,000 美元或更少。在调整受访者的社会人口特征、症状严重程度、功能状态和创伤史后，黑人因 PTSD 而获得服务的比例为 43%，而其他受访者为 56%（P = 0.003）。结论。即使在调整了 PTSD 严重程度和功能状态的差异后，黑人因 PTSD 接受服务的比率仍大大低于其他退伍军人。
BACKGROUND. "Service connected" veterans are those with documented, compensative conditions related to or aggravated by military service, and they receive priority for enrollment into the Veterans Affairs (VA) health care system. For some veterans, service connection represents the difference between access to VA health care facilities and no access.OBJECTIVES. To determine whether there are racial discrepancies in the granting of service connection for posttraumatic stress disorder (PTSD) by the Department of Veterans Affairs and, if so, to determine whether these discrepancies could be attributed to appropriate subject characteristics, such as differences in PTSD symptom severity or functional status.RESEARCH DESIGN. Mailed survey linked to administrative data. Claims audits were conducted on 11% of the sample.SETTING AND SUBJECTS. The study comprised 2700 men and 2700 women randomly selected from all veterans filing PTSD disability claims between January 1, 1994 and December 31, 1998.RESULTS. A total of 3337 veterans returned useable surveys, of which 17% were black. Only 16% of respondents carried private health insurance, and 44% reported incomes of $20,000 or less. After adjusting for respondents' sociodemographic characteristics, symptom severity, functional status, and trauma histories, black persons' rate of service connection for PTSD was 43% compared with 56% for other respondents (P = 0.003).CONCLUSION. Black persons' rates of service connection for PTSD were substantially lower than other veterans even after adjusting for differences in PTSD severity and functional status.