Missed opportunities: fewer service referrals after positive alcohol misuse screens in VA primary care.

OBJECTIVE

The primary purpose of this study was to compare referral to additional clinical services after primary care clinicians screened for and found a positive screen for alcohol misuse, depression, or posttraumatic stress disorder (PTSD).

METHODS

Results from the Alcohol Use Disorders Identification Test, Patient Health Questionnaire 2, and Primary Care PTSD screens performed over two years at the Philadelphia Veterans Affairs (VA) Medical Center and affiliated VA community sites were analyzed by mixed-effects logistic regression. A total of 9,052 veterans with positive screens were eligible for additional clinical services.

RESULTS

Odds of referral to additional clinical services for positive depression or PTSD screens were significantly higher than for positive screens for alcohol misuse (odds ratio=10.60 and 19.49, respectively).

CONCLUSION

Primary care-based screening for alcohol misuse is managed differently than for depression or PTSD.