Rogers Thea J, Smith Bridget M, Weaver Frances M, Ganesh Shanti, Saban Karen L, Stroupe Kevin T, Martinez Rachael N, Evans Charlesnika T, Pape Theresa L-B
Department of Veterans Affairs (VA), Center for Management of Complex Chronic Care (CMC3) .
Brain Inj. 2014;28(11):1406-12. doi: 10.3109/02699052.2014.919537. Epub 2014 Jun 19.
Mild traumatic brain injury (TBI) is a significant problem for Veterans. Gender differences in mild TBI outcomes such as return-to-work, resolution of symptoms and mental health diagnoses have been reported. The purpose of the study is to characterize gender differences in VA healthcare utilization in the year following mild TBI diagnosis.
This was a retrospective database study of 12 144 Veterans diagnosed with mild TBI in fiscal year 2008 and their healthcare utilization in the following year.
The mean age was 43.6 ± 17 and the majority were men (94.1%). Overall, women had more outpatient utilization than men with mild TBI (mean: 48 vs. 37 visits; p ≤ 0.001). Adjusted analyses indicated that women had a rate of outpatient utilization 25% higher than men (IRR = 1.25, 95% CI = 1.17-1.33). It was found that 13.6% of the difference in outpatient utilization by gender could be explained by other factors such as race, age, marital status, geographic location and illness burden.
Male Veterans had less outpatient utilization than females in the year following mild TBI diagnosis. Gender and other factors only accounted for a small portion of the differences observed; therefore, gender only partially accounts for differences in healthcare utilization following mild TBI.
轻度创伤性脑损伤(TBI)对退伍军人来说是一个重大问题。已有报道称,在轻度TBI的预后方面存在性别差异,如重返工作岗位、症状缓解和心理健康诊断等。本研究的目的是描述轻度TBI诊断后一年内退伍军人医疗保健利用方面的性别差异。
这是一项回顾性数据库研究,研究对象为2008财年被诊断为轻度TBI的12144名退伍军人及其次年的医疗保健利用情况。
平均年龄为43.6±17岁,大多数为男性(94.1%)。总体而言,患有轻度TBI的女性门诊就诊次数多于男性(平均:48次对37次;p≤0.001)。校正分析表明,女性门诊就诊率比男性高25%(风险比=1.25,95%置信区间=1.17-1.33)。研究发现,性别导致的门诊就诊差异中有13.6%可由种族、年龄、婚姻状况、地理位置和疾病负担等其他因素解释。
在轻度TBI诊断后的一年内,男性退伍军人的门诊就诊次数少于女性。性别和其他因素仅占观察到的差异的一小部分;因此,性别仅部分解释了轻度TBI后医疗保健利用的差异。