title: Predicting costs of Veterans Affairs health care in Gulf War veterans with medically unexplained physical symptoms.
abstract: Measures of post-traumatic stress disorder (PTSD) and depression were used to predict Veterans Affairs outpatient treatment costs among Persian Gulf War veterans with medically unexplained physical symptoms. Patients (N = 206) enrolled in a Veterans Affairs primary care clinic for Persian Gulf War veterans completed study assessments at the initial appointment or at a proximal follow-up visit. Costs of care for mental health, medical, and pharmacy services for these veterans were computed for the subsequent 6-month period. Depression and PTSD symptoms explained a significant share of variance in costs of mental health care and pharmacy services, after adjustment for covariates. None of the mental status measures was significantly related to costs of medical care. Models using global measures of mental health status were as robust as models using disorder-specific measures of PTSD and depression in predicting mental health care and pharmacy costs. The implications of these findings for anticipating costs of care for Persian Gulf War veterans are discussed.
authors.affiliation: VA Puget Sound Health Care System and University of Washington School of Medicine, Seattle, WA 98108, USA.
authors.forename: Miles
authors.initials: M
authors.lastname: McFall
authors.forename: Jan
authors.initials: J
authors.lastname: Tackett
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Maciejewski
authors.forename: Ralph D
authors.initials: RD
authors.lastname: Richardson
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Hunt
authors.forename: Lisa
authors.initials: L
authors.lastname: Roberts
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006787:Hospitals, Veterans / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data; D018923:Persian Gulf Syndrome / Q000191:economics*; D011446:Prospective Studies; D011602:Psychophysiologic Disorders / Q000191:economics*; D013313:Stress Disorders, Post-Traumatic / Q000191:economics*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*; D014861:Washington