Maynard Charles, Batten Adam, Liu Chuan-Fen, Nelson Karin, Fihn Stephan D
Departments of *Veterans Affairs Puget Sound Health Care System †Health Services ‡Veterans Affairs Office of Clinical System Development and Evaluation §Medicine, University of Washington, Seattle, WA.
Med Care. 2017 Nov;55(11):965-969. doi: 10.1097/MLR.0000000000000806.
Little is known about how Veterans with service-connected conditions use health care provided by the Veterans Health Administration (VHA).
To ascertain what proportion of Veterans with service-connected conditions used VHA health care and whether it varied according to type of condition, combined disability rating, age, sex, military rank, or other characteristics and whether there were differences in receipt of inpatient and outpatient care.
Cross-sectional analysis of administrative benefits and claims data for 2015 and 2016.
In total, 4,029,672 Veterans who had an active award status for service-connected conditions in October 2016.
Independent variables included age, sex, military rank, service branch, combined disability rating, Agent Orange exposure, and type of service-connected condition. The key-dependent variable was VHA health care use including specific types of health care utilization such as inpatient and outpatient services.
In total, 52% of those with service-connected conditions used VHA health care. Type of condition and disability rating were associated with use. Over 65% of those with major depression, posttraumatic stress disorder (PTSD), Agent Orange exposure, or diabetes used VHA health care, as did 76% of those with a 100% rating. Almost one third of users of VHA health care were compensated for PTSD. In general, both inpatient and outpatient mental health services were frequently used by Veterans with service-connected mental health conditions.
Veterans with service-connected conditions, particularly those with diabetes or mental illness such as depression or PTSD, depend heavily upon VHA for health care, including mental health services.
对于患有与服役相关疾病的退伍军人如何使用退伍军人健康管理局（VHA）提供的医疗服务，人们知之甚少。
确定患有与服役相关疾病的退伍军人中使用VHA医疗服务的比例，以及该比例是否因疾病类型、综合残疾评级、年龄、性别、军衔或其他特征而有所不同，同时确定在接受住院和门诊护理方面是否存在差异。
对2015年和2016年行政福利和索赔数据进行横断面分析。
2016年10月共有4,029,672名患有与服役相关疾病且处于有效奖励状态的退伍军人。
自变量包括年龄、性别、军衔、军种、综合残疾评级、接触橙剂情况以及与服役相关的疾病类型。关键因变量是VHA医疗服务的使用情况，包括住院和门诊服务等特定类型的医疗服务利用情况。
总体而言，患有与服役相关疾病的退伍军人中有52%使用了VHA医疗服务。疾病类型和残疾评级与使用情况相关。患有重度抑郁症、创伤后应激障碍（PTSD）、接触橙剂或糖尿病的退伍军人中，超过65%使用了VHA医疗服务，残疾评级为100%的退伍军人中这一比例为76%。几乎三分之一的VHA医疗服务使用者因PTSD获得了补偿。一般来说，患有与服役相关心理健康问题的退伍军人经常使用住院和门诊心理健康服务。
患有与服役相关疾病的退伍军人，尤其是患有糖尿病或抑郁症、PTSD等精神疾病的退伍军人，在很大程度上依赖VHA提供医疗服务，包括心理健康服务。
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