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Psychiatric Correlates of Medical Care Costs among Veterans Receiving Mental Health Care

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Title: Psychiatric Correlates of Medical Care Costs among Veterans Receiving Mental Health Care
Language: English
Authors: Simpson, Tracy L., Moore, Sally A., Luterek, Jane
Source: Journal of Interpersonal Violence. Apr 2012 27(6):1005-1022.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: http://sagepub.com
Peer Reviewed: Y
Physical Description: PDF
Page Count: 18
Publication Date: 2012
Document Type: Journal Articles
Reports - Research
Descriptors: Mental Health, Posttraumatic Stress Disorder, Medical Services, Severity (of Disability), Patients, Costs, Veterans, Correlation, Interviews, At Risk Persons, Symptoms (Individual Disorders), Clinical Diagnosis, Regression (Statistics), Referral, Mental Disorders
DOI: 10.1177/0886260511424496
ISSN: 0886-2605
Abstract: Research on increased medical care costs associated with posttraumatic sequelae has focused on posttraumatic stress disorder (PTSD). However, the provisional diagnosis of Disorders of Extreme Stress Not Otherwise Specified (DESNOS) encompasses broader trauma-related difficulties and may be uniquely related to medical costs. We investigated whether DESNOS severity was associated with greater nonmental health medical care costs in veterans receiving mental health care. Participants were 106 men and 105 women receiving VA outpatient mental health treatment. A standardized interview assessed DESNOS severity. The dependent variables consisted of primary and specialty medical treatment costs. Sequential zero-inflated negative binomial regression was used to evaluate the variance in medical costs accounted for by DESNOS severity, controlling for PTSD severity and established predisposing, enabling, and need-based health care factors. Contrary to our hypothesis, in fully adjusted models, DESNOS severity independently added a significant amount of variance to lower specialty medical care costs, whereas PTSD did not consistently account for significant variance in medical care costs. Greater DESNOS severity appears to be associated with lower specialty medical care costs but not primary care costs. These findings may indicate that patients with DESNOS symptoms are at risk for being underreferred for specialty care. (Contains 4 tables.)
Abstractor: As Provided
Number of References: 38
Entry Date: 2012
Accession Number: EJ987221
Database: ERIC
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  Data: Psychiatric Correlates of Medical Care Costs among Veterans Receiving Mental Health Care
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Interpersonal+Violence%22"><i>Journal of Interpersonal Violence</i></searchLink>. Apr 2012 27(6):1005-1022.
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  Data: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: http://sagepub.com
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  Data: Journal Articles<br />Reports - Research
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  Data: <searchLink fieldCode="DE" term="%22Mental+Health%22">Mental Health</searchLink><br /><searchLink fieldCode="DE" term="%22Posttraumatic+Stress+Disorder%22">Posttraumatic Stress Disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+Services%22">Medical Services</searchLink><br /><searchLink fieldCode="DE" term="%22Severity+%28of+Disability%29%22">Severity (of Disability)</searchLink><br /><searchLink fieldCode="DE" term="%22Patients%22">Patients</searchLink><br /><searchLink fieldCode="DE" term="%22Costs%22">Costs</searchLink><br /><searchLink fieldCode="DE" term="%22Veterans%22">Veterans</searchLink><br /><searchLink fieldCode="DE" term="%22Correlation%22">Correlation</searchLink><br /><searchLink fieldCode="DE" term="%22Interviews%22">Interviews</searchLink><br /><searchLink fieldCode="DE" term="%22At+Risk+Persons%22">At Risk Persons</searchLink><br /><searchLink fieldCode="DE" term="%22Symptoms+%28Individual+Disorders%29%22">Symptoms (Individual Disorders)</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+Diagnosis%22">Clinical Diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Regression+%28Statistics%29%22">Regression (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Referral%22">Referral</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Disorders%22">Mental Disorders</searchLink>
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  Data: 10.1177/0886260511424496
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  Data: 0886-2605
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Research on increased medical care costs associated with posttraumatic sequelae has focused on posttraumatic stress disorder (PTSD). However, the provisional diagnosis of Disorders of Extreme Stress Not Otherwise Specified (DESNOS) encompasses broader trauma-related difficulties and may be uniquely related to medical costs. We investigated whether DESNOS severity was associated with greater nonmental health medical care costs in veterans receiving mental health care. Participants were 106 men and 105 women receiving VA outpatient mental health treatment. A standardized interview assessed DESNOS severity. The dependent variables consisted of primary and specialty medical treatment costs. Sequential zero-inflated negative binomial regression was used to evaluate the variance in medical costs accounted for by DESNOS severity, controlling for PTSD severity and established predisposing, enabling, and need-based health care factors. Contrary to our hypothesis, in fully adjusted models, DESNOS severity independently added a significant amount of variance to lower specialty medical care costs, whereas PTSD did not consistently account for significant variance in medical care costs. Greater DESNOS severity appears to be associated with lower specialty medical care costs but not primary care costs. These findings may indicate that patients with DESNOS symptoms are at risk for being underreferred for specialty care. (Contains 4 tables.)
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PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ987221
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        Value: 10.1177/0886260511424496
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 18
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    Subjects:
      – SubjectFull: Mental Health
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      – SubjectFull: Posttraumatic Stress Disorder
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      – SubjectFull: Medical Services
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      – SubjectFull: Severity (of Disability)
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      – SubjectFull: Patients
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      – SubjectFull: Costs
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      – SubjectFull: Veterans
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      – SubjectFull: Correlation
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      – SubjectFull: Interviews
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      – SubjectFull: At Risk Persons
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      – SubjectFull: Symptoms (Individual Disorders)
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      – SubjectFull: Regression (Statistics)
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      – SubjectFull: Referral
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      – SubjectFull: Mental Disorders
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    Titles:
      – TitleFull: Psychiatric Correlates of Medical Care Costs among Veterans Receiving Mental Health Care
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            NameFull: Moore, Sally A.
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