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Brief Reports   |    
Health Care Utilization Prior to Loss to Care Among Veterans With Serious Mental Illness
Kristen M. Abraham, Ph.D.; Zongshan Lai, M.P.H.; Nicholas W. Bowersox, Ph.D.; David E. Goodrich, Ed.D.; Stephanie Visnic, B.A.; Jeffrey P. Burk, Ph.D.; Amy M. Kilbourne, Ph.D., M.P.H.
Psychiatric Services 2013; doi: 10.1176/appi.ps.002382012
View Author and Article Information

All of the authors with the exception of Dr. Burk are affiliated with the Veterans Affairs (VA) National Serious Mental Illness Treatment Resource and Evaluation Center, VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan. Dr. Abraham, Mr. Lai, Dr. Bowersox, Dr. Goodrich, and Dr. Kilbourne are also with the Department of Psychiatry, University of Michigan Medical School, North Campus Research Complex, Building 16, 2800 Plymouth Rd., Ann Arbor, MI 48109 (e-mail: krabraha@umich.edu). Dr. Burk is with the Office of Mental Health Services, Patient Care Services, Veterans Health Administration, Washington, D.C.

Copyright © 2013 by the American Psychiatric Association

Abstract

Objective  This study examined the association between utilization of Veterans Affairs (VA) health services and the probability of treatment dropout among veterans with serious mental illness.

Methods  Utilization of VA health services in the fiscal year (FY) before treatment dropout among veterans with serious mental illness who were lost to care for at least 12 months beginning in FYs 2008 or 2009 (N=6,687) was compared with utilization in FYs 2007 or 2008 among veterans with serious mental illness who remained in care (N=6,687).

Results  The veterans (mean age=54) were predominantly male (91%) and Caucasian (76%). After accounting for demographic and clinical variables, the analyses found that more primary care and mental health outpatient visits and fewer general medical and mental health hospitalizations were associated with lower odds of dropout.

Conclusions  Engagement in outpatient health care was associated with lower odds of loss to care among veterans with serious mental illness.

Abstract Teaser
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Anchor for Jump
Table 1Characteristics of 13,374 veterans with serious mental illness and their association with loss to care
Table Footer Note

a Operation Enduring Freedom/Operation Iraqi Freedom

Table Footer Note

b Scores were dichotomized; possible scores are 1, indicating the presence of ≥3 comorbid conditions, or 0, indicating <3 comorbid conditions (14).

Table Footer Note

*p<.05, **p≤.01, ***p<.001

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Priority Research Topics: Homelessness. Washington, DC, US Department of Veterans Affairs, 2012. Available at www.hsrd.research.gov/for_researchers/homelessness.cfm
 
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