Citation

Miles S, Sayer N, Belanger H, Venkatachalam H, Kozel FA, Toyinbo P, McCart J, Luther S. J. Neurotrauma 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2022.0176

PMID

35898115

Abstract

The Veterans' Health Administration (VHA) screens veterans who deployed in support of the wars in Afghanistan and Iraq for traumatic brain injury (TBI) and mental health (MH) disorders. Chronic symptoms after mild TBI overlap with MH symptoms, for which there are already established screens within VHA. It is unclear if the TBI screen facilitates treatment for appropriate specialty care over and beyond the MH screens. Our primary objective was to determine whether TBI screening is associated with different types (MH, Physical Medicine & Rehabilitation [PM&R], and Neurology) and frequency of specialty services compared to the MH screens. A retrospective cohort design examined veterans receiving VHA care who were screened for both TBI and MH disorders between Fiscal Year (FY) 2007 and FY 2018 (N = 241,136). We calculated service utilization counts in MH, PM&R, and Neurology in the 6 months after the screens. Zero-inflated negative binomial regression models of encounters (counts) were fit separately by specialty care type and for a total count of specialty services. We found that screening positive for TBI resulted in 2.38 times more specialty service encounters than screening negative for TBI. Compared to screening positive for MH only, screening positive for both MH and TBI resulted in 1.78 times more specialty service encounters and 1.33 times more MH encounters. The TBI screen appears to increase use of MH, PM&R, and Neurology services for veterans with post-deployment health concerns, even in those also identified as having a possible MH disorder.

Language: en

Keywords

ADULT BRAIN INJURY; MILITARY INJURY; TRAUMATIC BRAIN INJURY