AI Article Synopsis
- This study compared the health diagnoses, service usage, and costs among veterans with mild traumatic brain injury (mTBI) categorized into blast-related (BR), non-blast-related (NBR), and no mTBI groups.
- Veterans with BR mTBI had greater exposure to combat and detonations, leading to higher rates of headache, PTSD, and anxiety compared to NBR and no mTBI veterans.
- Those with BR mTBI also showed the highest annual health service utilization and costs, signaling the need for further research on their healthcare needs and access to services.
Article Abstract
Objective: To compare Veterans Health Administration (VHA) diagnoses, health services utilization, and costs by mild traumatic brain injury (mTBI) group (blast-related [BR] mTBI vs non-blast-related [NBR] mTBI vs no mTBI) among Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) veterans in the Chronic Effects of Neurotrauma Consortium multicenter observational study.
Design: Prospective cohort study.
Setting: Four Veterans Affairs Medical Centers.
Participants: OEF/OIF/OND veterans (N=472) who used Veterans Affairs Medical Centers services between 2002-2017.
Interventions: Not applicable. Lifetime mTBI history was assessed via semistructured interviews.
Main Outcome Measures: VHA diagnoses, health services utilization, and costs.
Results: Relative to NBR mTBI and no mTBI, veterans with BR mTBI were more likely to be male, have greater combat, and have controlled and uncontrolled detonations exposures (median BR, 15.0 vs NBR, 3.0 vs no mTBI, 3.0). They also had higher prevalence of headache, posttraumatic stress disorder, and anxiety diagnoses. Veterans with BR had the highest site-adjusted mean annual VHA utilization (26.31 visits; 95% confidence interval [CI], 26.01-26.61) relative to NBR (20.43 visits; 95% CI, 20.15-20.71) and no mTBI (16.62 visits; 95% CI, 16.21-17.04) and highest site adjusted mean annual VHA outpatient costs ($6480; 95% CI, $5842-$7187) relative to NBR ($4901; 95% CI, $4392-$5468) and no mTBI ($4069; 95% CI, $3404-$4864).
Conclusions: Veterans with BR mTBI had higher exposure to combat and detonation. BR was associated with greater prevalence of select diagnoses and higher health services utilization and costs relative to NBR and no mTBI. The role of health care needs from mTBI polytrauma, other deployment-related exposures, and VHA access warrants future research.
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| http://dx.doi.org/10.1016/j.apmr.2020.06.008 | DOI Listing |
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