Table 4.
Health Service Use in 159,705 Operation Enduring Freedom/Operation Iraqi Freedom Veterans Diagnosed with Posttraumatic Stress Disorder With and Without Alcohol Abuse or Dependence, by Gender
| |
Women |
Men |
||
|---|---|---|---|---|
| Use | PTSD with AUD n=2,461 n (%) | PTSD without AUD n=12,842 n (%) | PTSD with AUD n=41,121 n (%) | PTSD without AUD n=103,281 n (%) |
| Mental health outpatienta | ||||
| Any visit (yes/no) | 2,444 (99.3) | 12,244 (95.3) | 40,549 (98.6) | 97,352 (94.3) |
| Mean number of visits (SD)(per person per year) | 12.77±20.84 | 5.41±8.37 | 10.55±17.66 | 4.50±7.46 |
| Median (IQR) (per person per year) | 6.30 (2.75–13.94) | 2.79 (1.02–6.61) | 4.84 (2.02–11.58) | 2.23 (0.81–5.27) |
| IRR (95% CI) | 2.4 (2.3-2.5) | 1 | 2.4 (2.4-2.4) | 1 |
| Adj IRRb (95% CI) | 2.4 (2.3-2.6) | 1 | 2.4 (2.4-2.5) | 1 |
| Mental health inpatienta | ||||
| Any visit (yes/no) | 811 (33.0) | 811 (6.3) | 12,259 (29.8) | 5,949 (5.8) |
| Mean number of visits (SD) (per person per year) | 0.26±0.66 | 0.03±0.21 | 0.24±0.68 | 0.03±0.22 |
| Median (IQR) (per person per year) | 0.00 (0.00–0.23) | 0.00 (0.00–0.00) | 0.00 (0.00–0.21) | 0.00 (0.00–0.00) |
| IRR (95% CI) | 8.5 (7.4-9.7) | 1 | 8.7 (8.4-9.0) | 1 |
| Adj IRRb (95% CI) | 8.5 (7.4-9.7) | 1 | 8.4 (8.1-8.7) | 1 |
| Primary carea | ||||
| Any visit (yes/no)** | 2,397 (97.4) | 12,366 (96.3) | 39,159 (95.2) | 96,793 (93.7) |
| Mean number of visits (SD)(per person per year) | 2.93±2.37 | 2.57±2.22 | 2.01±2.76 | 1.84±2.24 |
| Median (IQR) (per person per year) | 2.40 (1.32–3.96) | 2.06 (1.06–3.52) | 1.55 (0.80–2.63) | 1.39 (0.65–2.46) |
| IRR (95% CI) | 1.15 (1.11-1.19) | 1 | 1.12 (1.11-1.13) | 1 |
| Adj IRRb (95% CI) | 1.16 (1.12-1.20) | 1 | 1.16 (1.14-1.17) | 1 |
| Emergency visitsa | ||||
| Any visit (yes/no) | 1,669 (67.8) | 6,582 (51.3) | 24,802 (60.3) | 44,603 (43.2) |
| Mean number of visits (SD) (per person per year) | 1.02±1.61 | 0.53±1.09 | 0.75±1.48 | 0.41±0.99 |
| Median (IQR) (per person per year) | 0.48 (0.00–1.31) | 0.14 (0.00–0.64) | 0.30 (0.00–0.95) | 0.00 (0.00–0.47) |
| IRR (95% CI) | 1.93 (1.80-2.1) | 1 | 1.86 (1.82-1.89) | 1 |
| Adj IRRb (95% CI) | 1.84 (1.72-1.97) | 1 | 1.78 (1.74-1.81) | 1 |
a
Unless otherwise noted, all within-gender comparisons have p<0.0001.
b
Incidence rate ratios (IRR) for the negative binomial regression model adjusted for age, race, marital status, component type, rank, service branch, multiple deployment, distance to nearest facility, closest VA facility type, and time in VA system since first clinical encounter. Because of missing values for some covariates, the n for multivariate analysis in women was 14,962, and the n for men was 142,079.
**
Within women, p=0.0064.
AUD, alcohol use disorder.