title: Medical care needs of returning veterans with PTSD: their other burden.
abstract: BACKGROUND
  There has been considerable focus on the burden of mental illness (including post-traumatic stress disorder, PTSD) in returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans, but little attention to the burden of medical illness in those with PTSD.
  
  
  OBJECTIVE
  (1) Determine whether the burden of medical illness is higher in women and men OEF/OIF veterans with PTSD than in those with No Mental Health Conditions (MHC). (2) Identify conditions common in those with PTSD.
  
  
  METHODS
  Cross-sectional study using existing databases (Fiscal Year 2006-2007).
  
  
  METHODS
  Veterans Health Administration (VHA) patients nationally.
  
  
  METHODS
  All 90,558 OEF/OIF veterans using VHA outpatient care nationally, categorized into strata: PTSD, Stress-Related Disorders, Other MHCs, and No MHC.
  
  
  METHODS
  (1) Count of medical conditions; (2) specific medical conditions (from ICD9 codes, using Agency for Health Research and Quality's Clinical Classifications software framework).
  
  
  RESULTS
  The median number of medical conditions for women was 7.0 versus 4.5 for those with PTSD versus No MHC (p<0.001), and for men was 5.0 versus 4.0 (p<0.001). For PTSD patients, the most frequent conditions among women were lumbosacral spine disorders, headache, and lower extremity joint disorders, and among men were lumbosacral spine disorders, lower extremity joint disorders, and hearing problems. These high frequency conditions were more common in those with PTSD than in those with No MHC.
  
  
  CONCLUSIONS
  Burden of medical illness is greater in women and men OEF/OIF veteran VHA users with PTSD than in those with No MHC. Health delivery systems serving them should align clinical program development with their medical care needs.
authors.affiliation: Center for Health Care Evaluation, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA 94025, USA. sfrayne@stanford.edu
authors.forename: Susan M
authors.initials: SM
authors.lastname: Frayne
authors.forename: Victor Y
authors.initials: VY
authors.lastname: Chiu
authors.forename: Samina
authors.initials: S
authors.lastname: Iqbal
authors.forename: Eric A
authors.initials: EA
authors.lastname: Berg
authors.forename: Kaajal J
authors.initials: KJ
authors.lastname: Laungani
authors.forename: Ruth C
authors.initials: RC
authors.lastname: Cronkite
authors.forename: Joanne
authors.initials: J
authors.lastname: Pavao
authors.forename: Rachel
authors.initials: R
authors.lastname: Kimerling
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods / Q000523:psychology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D014728:Veterans / Q000523:psychology