Patient Care

Health Care Utilization of Veterans With Serious Mental Illness

Fed Pract. 2017 March;34(suppl 2):14S-19S

References

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Independent-groups t test showed significant group differences in mean number of nonpsychiatric hospitalizations (t[2,328.68] = 5.00, P < .01). Veterans with combat flags averaged significantly fewer nonpsychiatric hospitalizations per year (mean, 0.34; SD, .99) than did veterans without flags (mean, 0.51; SD, 1.71), even with age as a covariate (F[1, 10,675] = 9.81, P < .01).

Independent-groups t test showed significant group differences in mean number of psychiatric hospitalizations (t[2,706.75] = 7.69, P < .01). Veterans with combat flags averaged significantly fewer psychiatric hospitalizations per year (mean, 0.31; SD, 0.91) than did veterans without flags (mean, 0.55; SD, 1.80), even with age as a covariate (F[1, 10,675] = 23.51, P < .01).

Group Differences by SMI Diagnosis

Mean number of visits. Analysis of covariance (ANCOVA) was used to determine differences among the SMI groups (schizophrenic, psychotic, bipolar, depressive, and mood disorders) in mean number of outpatient visits per year with age as a covariate. With age accounted for, there were significant differences among the SMI groups (F[4, 11,129] = 285.02, P < .01). Therefore, pairwise comparisons were used to examine differences among individual disorders. Veterans with schizophrenic disorders averaged more visits per year (mean, 16.2; SD, 27.12) than did veterans with bipolar disorders (mean, 6.4; SD, 7.8, P < .01) and veterans with MDD (mean, 4.8; SD, 5.5, P < .01). Veterans with schizophrenia also averaged more visits per year than did veterans with mood disorders NOS (mean, 5.2; SD, 5.9, P < .01) and veterans with unspecified psychotic disorders (mean, 5.9; SD, 9.6, P < .01).

Nonpsychiatric hospitalizations . An ANCOVA analysis was used to determine group differences in nonpsychiatric hospitalizations per year with SMI diagnosis as the independent variable and age as a covariate. With age accounted for, there were significant differences among the SMI groups (F[4, 11,129] = 143.02, P < .01). Furthermore, pairwise comparisons were used to examine differences among individual disorders. Veterans with schizophrenic disorders averaged more nonpsychiatric hospitalizations (mean, 1.4; SD, 3.4) than did veterans with bipolar disorders (mean, 0.7; SD, 1.8, P < .01) and veterans with MDD (mean, 0.3; SD, 0.9, P < .01). Veterans with schizophrenia averaged more nonpsychiatric hospitalizations per year than did veterans with mood disorders NOS (mean, 0.3; SD, 0.8, P < .01) and veterans with unspecified psychotic disorders (mean, 0.5; SD, 1.2, P < .01).

Psychiatric hospitalizations. An ANCOVA analysis was used to determine group differences in psychiatric hospitalizations per year with SMI diagnosis as the independent variable and age as a covariate. With age accounted for, there were significant differences among the SMI groups (F[4, 11,129] = 204.64, P < .01). Furthermore, pairwise comparisons were used to examine differences among individual disorders. Veterans with schizophrenic disorders averaged more psychiatric hospitalizations per year (mean, 1.6; SD, 3.4) than did veterans with bipolar disorders (mean, 0.7; SD, 1.9, P < .01) and veterans with MDD (mean, 0.3; SD, 1.0, P < .01). Veterans with schizophrenia averaged more psychiatric hospitalizations per year than did veterans with mood disorders NOS (mean, 0.2; SD, 0.8, P < .01) and veterans with unspecified psychotic disorders (mean, 0.9; SD, 1.8, P < .01).