Greater Burden of Medical Illness among OEF/OIF Veterans with PTSD Compared to OEF/OIF Veterans without PTSD
FINDINGS:
- Among women and men OEF/OIF Veterans who used VA outpatient care between FY06 and FY07, the burden of medical illness (measured as a count of diagnosed conditions) was greater for those with PTSD than for those with no mental health conditions.
- The median number of medical conditions for women Veterans was 7.0 for those with PTSD versus 4.5 for those with no mental health conditions; for men, the rates were 5.0 versus 4.0.
- For Veterans with PTSD, the most frequent conditions among women were lumbosacral spine disorders, headache, and lower extremity joint disorders; among men, the most frequent were lumbosacral spine disorders, lower extremity joint disorders, and hearing problems. These high-frequency conditions were more common in those with PTSD than in those with no mental health conditions.
BACKGROUND:
In response to recent attention to the high rates of PTSD in soldiers returning from OEF/OIF, there have been considerable efforts to characterize their burden of mental illness. However, general medical care needs of OEF/OIF Veterans with PTSD have not been characterized. This gap in information is important for many reasons, including the fact that their deployment experience (e.g., exposure to improvised explosive devices, heavy body armor, etc.) differs from that of Veterans of earlier eras. Thus, this study sought to determine whether the burden of medical illness is higher in OEF/OIF Veterans with PTSD who used VA outpatient care compared to OEF/OIF Veterans with no mental health conditions. Using VA data, investigators identified 90,558 OEF/OIF Veterans who used VA outpatient care from FY06-FY07. Veterans were categorized into four groups by mental health status: PTSD, stress-related disorders (SRD), other mental health conditions, or no mental health conditions. In addition, 15 medical condition categories were examined, such as: infectious diseases, neurologic/sense organs, circulatory, and musculoskeletal. All analyses were stratified by gender.
LIMITATIONS:
- ICD9 codes were used to ascertain both mental health and medical conditions, which could have contributed to either an under- or over-misrepresentation of certain conditions.
- Findings may not be generalizable to OEF/OIF Veterans who do not use VA healthcare, Veterans of other eras, or non-Veterans.
IMPLICATIONS:
- VA’s recent healthcare reorganization (e.g., patient-centered medical homes, mental health providers embedded in primary care settings, tele-mental health initiatives) may prove particularly beneficial for Veterans with comorbid PTSD and medical illness.
AUTHOR/FUNDING INFORMATION:
This study was funded by HSR&D (SDR 07-331, SHP 08-161, and IAE 05-291). Dr. Frayne and Mr. Chiu are part of HSR&D’s Center for Health Care Evaluation in Palo Alto, CA.
Frayne S, Chiu V, Iqbal S, et al. Medical Care Needs of Returning Veterans with PTSD: Their Other Burden. Journal of General Internal Medicine September 18, 2010;e-pub ahead of print.
