Study Identifies Differences in Mental Health Diagnoses among OEF/OIF Soldiers Transitioning from DoD to VA Care
BACKGROUND:
Ensuring continuity of care across institutions is a priority for both the Department of Defense (DoD) and VA. This study assessed the transition of healthcare from DoD to VA for service members traumatically injured in OEF/OIF, and their subsequent psychiatric care. Using DoD and VA data, investigators identified 994 OEF/OIF service members who received inpatient care at a DoD trauma treatment facility and were discharged between FY02 and FY06; 216 of these service members then transitioned into VA care. Investigators examined time to transition to VA care, mental health diagnoses, and prescription medication use. The entire study period was from FY02 through FY09, ending three years after the last year of discharge from DoD care.
FINDINGS:
- Although none of the 994 DoD inpatients received a diagnosis of PTSD, 21% (209) had other mental health diagnoses, primarily drug abuse (12%). Of the 216 service members who transitioned to VA care, 71% (153) subsequently had at least one psychiatric diagnosis, with PTSD (52%) and depression (40%) the most common.
- OEF/OIF service members who were discharged from DoD care in FY06 were more likely to transition into VA care (31%) than were patients discharged in earlier years.
- Of service members who sought VA care, 38% did so within six months of DoD discharge, and 75% within one year of discharge.
- Nearly 88% of those service members who transitioned to VA healthcare were still using VA care in the final year of the study, FY09. Treatment retention was significantly greater for those receiving psychiatric care: 98% vs. 62% for those not receiving psychiatric care.
LIMITATIONS:
- This study relied on administrative data. Data on DoD and non-VA civilian healthcare services use following discharge from inpatient DoD care were not available.
- Results were derived from one DoD hospital that included a burn unit, and may not apply to others.
- There was a lack of input from service members as to why they sought mental health treatment or failed to seek VA services.
IMPLICATIONS:
- Although physical trauma led to DoD hospitalization, high rates of psychiatric disorders identified in subsequent VA care suggest that evaluation of psychiatric problems is important throughout all phases of care.
AUTHOR/FUNDING INFORMATION:
This study was funded by HSR&D (SHP-08-0140). Drs. Copeland and Zeber are part of HSR&D’s Veterans Evidence-based Research, Dissemination, and Implementation Center in San Antonio, TX.
Copeland L, Zeber J, Bingham M, et al. Transition from Military to VHA Care: Psychiatric Health Services for Iraq/Afghanistan Combat-Wounded. Journal of Affective Disorders November 2, 2010;e-pub ahead of print.
