Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria
Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria
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DOI：
10.1371/journal.pone.0132664
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发表时间：
2015-07-14
期刊：
影响因子：
3.7
通讯作者：
Fargo, Jamison D.
中科院分区：
文献类型：
--
作者：
Peterson, Rachel;Gundlapalli, Adi V.;Fargo, Jamison D.
美国退伍军人事务部 (VA) 的研究人员使用行政标准来确定美国退伍军人中的无家可归情况。我们的目标是探索这些代码在 VA 医疗保健机构中的使用。我们检查了最近从军队退役并使用 VA 常规识别标准（ICD-9-CM 代码 V60.0、VA 无家可归服务特定代码）以及表明住房不稳定的密切相关的 V60 代码确定为无家可归者的 VA 健康记录（2002-2012）。逻辑回归分析检查了收到这些代码的退伍军人之间的差异。在确定无家可归者后 90 天内对医疗保健服务和合并症进行了分析。 VA 常规标准确定了来自持久自由、伊拉克自由和新黎明行动的 21,021 名无家可归的退伍军人（比率为 2.5%）。添加联盟 V60 代码后，该数量增加至 31,260 个（增长率为 3.3%）。虽然注意到某些人口统计差异，但使用传统或联合代码确定为无家可归的退伍军人在无家可归者的利用、心理健康和药物滥用服务以及合并症方面是相似的。全国退伍军人事务部设施中与无家可归者相关的诊断代码的使用模式存在差异。创建一个官方的 VA 无家可归案例定义，其中包括额外的 ICD-9-CM 和 VA 无家可归者服务的其他管理代码，可能会改进对无家可归者和高危退伍军人的识别。这也为鼓励在全国退伍军人管理局设施以及其他大型医疗保健组织中统一应用这些规范提供了机会。
Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.