Health Services Utilization, Health Care Costs, and Diagnoses by Mild Traumatic Brain Injury Exposure: A Chronic Effects of Neurotrauma Consortium Study.
Arch Phys Med Rehabil
; 101(10): 1720-1730, 2020 10.
Article
em En
| MEDLINE
| ID: mdl-32653582
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.DESIGN:
Prospective cohort study.SETTING:
Four Veterans Affairs Medical Centers.PARTICIPANTS:
OEF/OIF/OND veterans (N=472) who used Veterans Affairs Medical Centers services between 2002-2017.INTERVENTIONS:
Not applicable. Lifetime mTBI history was assessed via semistructured interviews. MAIN OUTCOMEMEASURES:
VHA diagnoses, health services utilization, and costs.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).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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transtornos de Estresse Pós-Traumáticos
/
Veteranos
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Concussão Encefálica
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Aceitação pelo Paciente de Cuidados de Saúde
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Gastos em Saúde
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Health_economic_evaluation
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Observational_studies
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Qualitative_research
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Female
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Humans
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Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Arch Phys Med Rehabil
Ano de publicação:
2020
Tipo de documento:
Article