Examination of trends in Veterans Health Administration (VHA) healthcare utilization and costs among veterans with mild traumatic brain injury (mTBI) is needed to inform policy, resource allocation, and treatment planning. The objective of this study was to assess the patterns of VHA healthcare utilization and costs in the 3 years following TBI screening among veterans with mTBI, compared with veterans without TBI. A retrospective cohort study of veterans who underwent TBI screening in fiscal year 2010 was conducted. We used VHA healthcare utilization and associated costs by categories of care to compare veterans diagnosed with mTBI (n = 7318) with those who screened negative (n = 75,294) and those who screened positive but had TBI ruled out (n = 3324). Utilization and costs were greatest in year 1, dropped in year 2, and then leveled off. mTBI diagnosis was associated with high rates of utilization. Each year, healthcare costs for those with mTBI were two to three times higher than for those who screened negative, and 20-25% higher than for those who screened positive but had TBI ruled out. A significant proportion of healthcare use and costs for veterans with mTBI were associated with mental health service utilization. The relatively high rate of VHA utilization and costs associated with mTBI over time demonstrates the importance of long-term planning to meet these veterans' needs. Identifying and engaging patients with mTBI in effective mental health treatments should be considered a critical component of treatment planning.
Bibliographical noteFunding Information:
Funding for the study was provided by the United States Department of Veterans Affairs, Office of Research and Development, Health Services Research & Development Service (HSR&D), Washington, DC through a locally initiated project grant (#PLY 05-2010-2) from the Polytrauma and Blast-Related Injuries (PT/BRI) Quality Enhancement Research Initiative (QUERI). The funding source had no role in the study design, analysis, interpretation of the data, writing of the article, or decision to submit the article for publication. Preliminary results related to this article were presented at the VA HSR&D Annual Meeting July 8–10, 2015, in Philadelphia, PA.
- emergency department
- traumatic brain injury