Bailey Beth A, Manning Todd, Peiris Alan N
Department of Family Medicine, East Tennessee State University, Johnson City, 37614, USA.
Mil Med. 2012 Jan;177(1):70-6. doi: 10.7205/milmed-d-11-00204.
Veterans have a profound degree of vitamin D deficiency that may contribute to adverse health outcomes. Some veterans, especially African Americans at high risk of vitamin D deficiency, may not be receiving appropriate attention. We hypothesized variations in vitamin D status and monitoring across six different VAMCs and that these differences are associated with health care costs. A retrospective analysis of the medical data in the Veterans Integrated Service Network 9 (Southeastern United States) was performed, yielding a sample of 15,340 veterans. Monitoring of vitamin D, vitamin D levels, and medical costs and services in all categories varied greatly by site. Memphis tested vitamin D levels less often despite the increased minority presence and high levels of deficiency. Vitamin D deficiency and lack of monitoring predicted increased inpatient health care costs at all sites, but did not fully account for site-cost variations in controlled analyses. Vitamin D deficiency remains a significant problem among veterans in the Southeastern United States and is closely linked to increased health care costs. We recommend protocols that recognize site differences and facilitate testing and monitoring of vitamin D levels, especially in high-risk groups of veterans.
退伍军人存在严重的维生素D缺乏问题，这可能会导致不良健康后果。一些退伍军人，尤其是维生素D缺乏风险较高的非裔美国人，可能未得到适当关注。我们推测六个不同退伍军人事务医疗中心（VAMC）的维生素D状况及监测存在差异，且这些差异与医疗保健成本相关。对退伍军人综合服务网络9（美国东南部）的医疗数据进行了回顾性分析，抽取了15340名退伍军人作为样本。各医疗中心在维生素D监测、维生素D水平以及各类医疗成本和服务方面差异很大。尽管孟菲斯少数族裔人口增加且维生素D缺乏水平较高，但对维生素D水平的检测频率较低。维生素D缺乏和监测不足预示着所有医疗中心的住院医疗成本都会增加，但在对照分析中并不能完全解释各医疗中心成本的差异。在美国东南部，维生素D缺乏仍是退伍军人中的一个重大问题，且与医疗保健成本增加密切相关。我们建议制定相关方案，以认识到各医疗中心的差异，并促进维生素D水平的检测和监测，尤其是在高危退伍军人群体中。
