Amara Jomana, Pogoda Terri K, Krengel Maxine, Iverson Katherine M, Baker Errol, Hendricks Ann
Defense Resources Management Institute, Naval Postgraduate School, 699 Dyer Road, 205A Halligan Hall, Monterey, CA 93943.
Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, 150 South Huntington Avenue, Jamaica Plain, MA 02130.
Mil Med. 2014 Sep;179(9):964-72. doi: 10.7205/MILMED-D-13-00559.
To determine the demographic and service characteristics that differentially impact utilization and cost of Veterans Health Administration (VHA) services for Operation Enduring Freedom and Operation Iraq Freedom (OEF/OIF) Veterans screened or evaluated for traumatic brain injury (TBI).
We examined Department of Defense (DoD) and VHA administrative records of OEF/OIF Veterans who were screened or evaluated for TBI.
Our study population was OEF/OIF Veterans who separated from DoD in Fiscal Years 2003-2009 and who were screened or evaluated in VHA for TBI between October 2008 and July 2009.
We describe the demographics and service characteristics of separated Veterans and those who accessed the VHA. We report the cost of VHA utilization and estimate a probit regression model to assess determinants of VHA utilization and costs by OEF/OIF Veterans screened and evaluated for TBI by VHA.
Females and Veterans older than 37 years utilize VHA services more intensely. Across all services, the Reserve Components utilize health services more than the Active Components placing more demand on VHA for services.
VHA utilization and costs is impacted by the demographic and service characteristics of Veterans. The variation in Veteran groups incurring higher costs and utilization indicates different usage patterns of VHA services by each group with implications for patient load as the DoD deploys higher numbers of females and the Reserve Components.
确定对接受过创伤性脑损伤（TBI）筛查或评估的持久自由行动和伊拉克自由行动（OEF/OIF）退伍军人使用退伍军人健康管理局（VHA）服务的利用率和成本有不同影响的人口统计学和服务特征。
我们检查了接受过TBI筛查或评估的OEF/OIF退伍军人的国防部（DoD）和VHA行政记录。
我们的研究人群是2003 - 2009财年从国防部分离出来、并于2008年10月至2009年7月期间在VHA接受过TBI筛查或评估的OEF/OIF退伍军人。
我们描述了已分离退伍军人和使用VHA服务的退伍军人的人口统计学和服务特征。我们报告了VHA服务的使用成本，并估计了一个概率回归模型，以评估接受VHA筛查和评估的OEF/OIF退伍军人使用VHA服务及成本的决定因素。
女性和37岁以上的退伍军人对VHA服务的使用更为频繁。在所有服务中，后备役军人比现役军人更多地使用医疗服务，这给VHA带来了更大的服务需求。
退伍军人的人口统计学和服务特征会影响VHA服务的使用和成本。不同退伍军人群体在成本和使用方面的差异表明，每个群体对VHA服务的使用模式不同，随着国防部部署更多女性和后备役军人，这对患者负担会产生影响。
