Mental Health Service Utilization before and after Receipt of a Service-Connected Disability Award for PTSD: Findings from a National Sample
Mental Health Service Utilization before and after Receipt of a Service-Connected Disability Award for PTSD: Findings from a National Sample
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DOI：
10.1111/1475-6773.12859
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发表时间：
2018-12-01
影响因子：
3.4
通讯作者：
McCarthy, John F.
中科院分区：
文献类型：
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作者：
Sripada, Rebecca K.;Hannemann, Claire M.;McCarthy, John F.
目的数据来源确定模式的精神卫生服务使用之前和之后的VA残疾赔偿金的创伤后应激障碍（PTSD）。2012年至2014年期间，VHA登记的退伍军人中有10%的随机样本与新的或增加的PTSD服务联系（n = 22，249）。研究设计数据提取方法我们使用潜在轨迹分析来识别利用模式，并使用多项式逻辑回归来评估退伍军人特征和轨迹成员之间的关联。我们评估了在PTSD残疾评级或评级增加之前和之后的52周内接受VHA心理健康遭遇的情况。最佳拟合模型分为五组：不使用（36.6%），低使用（37.7%），增加使用（9.4%），减少使用（11.2%）和高使用（5.1%）。根据人口统计学特征进行调整，与无使用组相比，其他组的退伍军人更有可能居住在离VHA设施更近的地方，获得更高的PTSD残疾评级，并对军事性创伤进行积极筛查。服务使用保持稳定（80%）或增加（9%）的绝大多数退伍军人。服务利用率仅下降了11%。数据并没有表明评级后实质性的服务中断。低VHA服务利用率表明有机会加强与PTSD相关残疾福利退伍军人的推广。
Objective Data Sources To determine patterns of mental health service use before and after VA disability compensation awards for posttraumatic stress disorder (PTSD). A 10 percent random sample of VHA-enrolled Veterans with new or increased PTSD service connection between 2012 and 2014 (n = 22,249). Study Design Data Extraction Methods We used latent trajectory analysis to identify utilization patterns and multinomial logistic regression to assess associations between Veteran characteristics and trajectory membership. We assessed receipt of VHA mental health encounters in each of the 52 weeks prior to and following PTSD disability rating or rating increase. Principal Findings Conclusions The best fitting model had five groups: No Use (36.6 percent), Low Use (37.7 percent), Increasing Use (9.4 percent), Decreasing Use (11.2 percent), and High Use (5.1 percent). Adjusting for demographic characteristics and compared with the No Use group, Veterans in the other groups were more likely to reside closer to a VHA facility, receive a higher PTSD disability rating, and screen positive for military sexual trauma. Service use remained stable (80 percent) or increased (9 percent) for the vast majority of Veterans. Service utilization declined for only 11 percent. Data did not indicate substantial service discontinuation following rating. Low VHA service utilization suggests opportunities to enhance outreach for Veterans with PTSD-related disability benefits.