Table 3.
Utilization of Non-Mental Health Medical Services During the First Year of VA Care by Mental Health Category*†‡§
| VA Medical Services | No MH Dx | MH Dx (no PTSD) | PTSD (± other) |
|---|---|---|---|
| N = 157,844 | N = 37,868 | N = 53,728 | |
| Primary care | |||
| Median no. visits (IQR) | 0 (0–1) | 1 (0–3) | 2 (1–3) |
| No. visits/100 person years | 93 | 194 | 223 |
| Unadjusted IRR | 1.00 | 2.10 (2.07–2.13) | 2.41 (2.38–2.44) |
| Adjusted IRR | 1.00 | 1.61 (1.59–1.63) | 1.85 (1.83–1.88) |
| Medical/surgical subspecialty | |||
| Median no. visits (IQR) | 0 (0–1) | 0 (0–1) | 0 (0–2) |
| No. visits/100 person years | 59 | 106 | 130 |
| Unadjusted IRR | 1.00 | 1.79 (1.75–1.83) | 2.18 (2.14–2.22) |
| Adjusted IRR | 1.00 | 1.55 (1.51–1.58) | 1.95 (1.92–1.99) |
| Ancillary services | |||
| Median no. visits (IQR) | 0 (0–1) | 1 (0–3) | 1 (0–4) |
| No. visits/100 person years | 132 | 262 | 350 |
| Unadjusted IRR | 1.00 | 1.99 (1.95–2.03) | 2.66 (2.61–2.70) |
| Adjusted IRR | 1.00 | 1.67 (1.64–1.70) | 2.19 (2.16–2.23) |
| Diagnostic tests/procedures | |||
| Median no. visits (IQR) | 1 (0–3) | 3 (1–5) | 3 (1–6) |
| No. visits/100 person years | 213 | 368 | 427 |
| Unadjusted IRR | 1.00 | 1.72 (1.70–1.74) | 2.00 (1.98–2.02) |
| Adjusted IRR | 1.00 | 1.50 (1.48–1.51) | 1.82 (1.80–1.84) |
| Emergency services | |||
| Median no. visits (IQR) | 0 (0–0) | 0 (0–1) | 0 (0–1) |
| No. visits/100 person years | 31 | 54 | 60 |
| Unadjusted IRR | 1.00 | 1.75 (1.70–1.79) | 1.95 (1.91–1.99) |
| Adjusted IRR | 1.00 | 1.42 (1.39–1.46) | 1.71 (1.67–1.74) |
| Inpatient | |||
| Median no. visits (IQR) § | 0 (0–0) | 0 (0–0) | 0 (0–0) |
| No. visits/100 person years | 1.4 | 4.2 | 4.4 |
| Unadjusted IRR | 1.00 | 3.09 (2.85–3.35) | 3.29 (3.06–3.54) |
| Adjusted IRR | 1.00 | 2.46 (2.26–2.68) | 2.70 (2.50–2.92) |
*IRR = Incident rate ratio, IQR = interquartile range, MH Dx = mental health diagnoses
†IRR adjusted for age, sex, race, marital status, component type, military rank, military branch, multiple deployments, main VA facility, facility type, and distance to nearest VA
‡All adjusted IRR between group comparisons P < 0.001 except p = 0.04 for comparison of inpatient utilization between MH Dx (no PTSD) and PTSD (± other)
§Medians and interquartile range =0 for some categories because of the relatively low proportion of people utilizing those services