Geographic Variation in Receipt of Electroconvulsive Therapy Among US Department of Veterans Affairs Patients.

Objective: The aim of the study is to characterize geographic variation in electroconvulsive therapy (ECT) receipt across the United States (US) Veterans Administration (VA) healthcare system and explore potential explanatory variables.

Background: ECT is a highly effective and rapidly acting treatment for multiple mental disorders. However, there may be geographic disparities in access to ECT across the US.

Development and validation of a prognostic index for mental health and substance use disorder burden.

Objective: To develop an accessible index which quantifies MHSUD burden among patients of Veterans Affairs hospitals.

Method: We used 21 disorder categories provided by the diagnostic and statistical manual (DSM) to characterize diagnoses among primary care (PC) patients. For each patient, we generated counts of unique disorder categories present during the PC encounter or in the year prior.

A comparison of mortality rates for buprenorphine versus methadone treatments for opioid use disorder.

Objective: Mortality from opioid use disorder (OUD) can be reduced for patients who receive opioid agonist treatment (OAT). In the United States (US), OATs have different requirements including nearly daily visits to a dispensing facility for methadone but weekly to monthly prescriptions for buprenorphine. Our objective was to compare mortality rates for buprenorphine and methadone treatments among a large sample of US patients with OUD.

Optimizing Data on Race and Ethnicity for Veterans Affairs Patients.

Introduction: Maintaining accurate race and ethnicity data among patients of the Veterans Affairs (VA) healthcare system has historically been a challenge. This work expands on previous efforts to optimize race and ethnicity values by combining multiple VA data sources and exploring race- and ethnicity-specific collation algorithms.

Materials And Methods: We linked VA patient data from 2000 to 2018 with race and ethnicity data from four administrative and electronic health record sources: VA Medical SAS files (MedSAS), Corporate Data Warehouse (CDW), VA Centers for Medicare extracts (CMS), and VA Defense Identity Repository Data (VADIR).

Veteran drug overdose mortality, 2010-2019.

Background: Prior work documents that Veteran drug overdose mortality increased from 2010 to 2016. The present study assessed trends from 2010 to 2019, by drug type and recent receipt of Veterans Health Administration (VHA) services, and compared rates for Veteran and non-Veteran US adults.

Methods: This retrospective cross-sectional study used data from Veterans Affairs (VA) medical records, the VA/Department of Defense Mortality Data Repository, and CDC WONDER.

Mortality after electroconvulsive therapy.

Background: There are limited studies examining mortality associated with electroconvulsive therapy (ECT), and many studies do not include a control group or method to identify all patient deaths.

Aims: We aimed to evaluate the risk of death associated with ECT treatments over 30 days and 1 year.

Method: We conducted a study analysing electronic medical record data from the Department of Veterans Affairs healthcare system between 2000 and 2017.

Small Area Analysis of Veterans Affairs Mental Health Services Data.

Objective: To identify geographic variation in mental health service use in the Department of Veterans Affairs (VA), the authors constructed utilization-based VA mental health service areas (MHSAs) for outpatient treatment and mental health referral regions (MHRRs) for residential and acute inpatient treatment.

Methods: MHSAs are empirically derived geographic groupings of one or more counties containing one or more VA outpatient mental health clinics. For each county within an MHSA, patients received most of their VA-provided outpatient mental health care within that MHSA.

Brief Report: Opioid-Involved Overdose Mortality in United States Veterans.

Background And Objectives: The purpose of this study is to assess trends in opioid-involved overdose mortality among US Veterans.

Methods: Age-adjusted drug overdose mortality rates, overall and by opioid subtype, were assessed from National Death Index data for US Veterans; statistical significance of trends was assessed for 2010 to 2015 and 2015 to 2016.

Results: Veteran age-adjusted overdose mortality rates increased 23.

Electroconvulsive Therapy in Veterans Health Administration Hospitals: Prevalence, Patterns of Use, and Patient Characteristics.

Objectives: The body of large-scale, epidemiological research on electroconvulsive therapy (ECT) in the United States is limited. To address this gap, we assessed demographic, clinical, pharmacological, and mental health treatment history as well as 2-year mortality outcomes associated with ECT use in the largest U.S.

Causes of Excess Mortality in Veterans Treated for Posttraumatic Stress Disorder.

Introduction: Published research indicates that posttraumatic stress disorder (PTSD) is associated with increased mortality. However, causes of death among treatment-seeking patients with PTSD remain poorly characterized. The study objective was to describe causes of death among Veterans with PTSD to inform preventive interventions for this treatment population.

Changing Trends in Opioid Overdose Deaths and Prescription Opioid Receipt Among Veterans.

Introduction: To inform overdose prevention, this study assessed both recent trends in opioid overdose mortality across opioid categories and receipt of prescription opioid analgesics among Veterans who died from overdose in the Veterans Health Administration.

Methods: Using Veterans Health Administration records linked to National Death Index data, annual cohorts (2010-2016) of Veterans who received Veterans Health Administration care were obtained and were examined by opioid overdose categories (natural/semisynthetic opioids, heroin, methadone, and other synthetic opioids) on (1) overdose rates and changes in rates adjusted for age, sex, and race/ethnicity; and (2) Veterans Health Administration prescription opioid receipt. Analyses were conducted in 2018.

Completing the Maternal Care Team: OB/GYN Expertise at Rural District Hospitals in Ghana, a Qualitative Study.

Introduction To provide a qualitative perspective on the changes that occurred after newly placed OB/GYNs began working at district hospitals in Ashanti, Ghana. Methods Structured interviews of healthcare professionals were conducted at eight district hospitals located throughout the Ashanti district of Ghana, four with and four without a full-time OB/GYN on staff. Individuals interviewed include: medical superintendents, medical officers, district hospital administrators, OB/GYNs (where applicable), and nurse-midwives.