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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

3116 — Prospective Longitudinal Study of Health Care Utilization among OEF/OIF Service Members with PTSD and Chronic Multisymptom Illness

McAndrew LM, WRIISC-NJ; D'Andrea EA, Philadelphia VA; Engel C, Walter Reed National Military Medical Center; Uniformed Services University of the Health Sciences; Yen CBatorsky B, and Ackerman AJ, WRIISC-NJ; Quigley , Edith Nourse Rogers VA Memorial Hospital; Northeastern University;

Objectives:
There are few studies on health care utilization of OEF/OIF military personnel after deployment and to our knowledge, no published prospective longitudinal studies. The current study was designed to characterize health care utilization and barriers to care among OEF/OIF personnel with post-traumatic stress disorder (PTSD) and chronic multisymptom illness (CMI) one year after returning from combat deployment. We also assessed changes in health care utilization from pre-deployment among these personnel.

Methods:
The HEROES Study, an HSR&D-funded prospective longitudinal study, assessed 790 National Guard and Reserve Army enlisted personnel pre-deployment, immediately post-deployment, 3-months, and 1 year post-deployment. Health care utilization questions were derived from the National Health Interview Survey. PTSD was assessed using the PTSD Checklist (PCL). CMI was assessed using the Fukuda et al. (1998) definition. We examined associations of health care utilization and barriers to care with PTSD and CMI at one year using cross-sectional analysis, and examined changes in utilization from pre- to 1-year post-deployment.

Results:
335 OEF/OIF service members completed the one year post-deployment assessment. 16.0% screened positive for PTSD and 57.2% screened positive for CMI. CMI was associated with an odds ratio of 3.78 for utilizing mental health care, an odds ratio of 2.28 for utilizing non-mental health specialty care, an odds ratio of 1.8 for visits to an emergency room, and reported more barriers to receiving care (r = .31). PTSD was associated with an odds ratio of 5.2 for utilizing mental health care, an odds ratio of 1.54 for utilizing non-mental health specialty care, an odds ratio of 1.90 for ER visits and those with more PTSD symptoms also reported more barriers to receiving care (r = .35). Additional longitudinal results will be reported.

Implications:
Returning military service members with PTSD or CMI have greater mental health and non-mental health care utilization and reported more barriers to care. To our knowledge, no study has characterized health care utilization among service members with CMI.

Impacts:
Like, PTSD, CMI is associated with greater health care utilization and barriers to care among OEF/OIF service members. CMI is an understudied health care concern that has significant implications for health care utilization.


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