title: Missed opportunities: fewer service referrals after positive alcohol misuse screens in VA primary care.
abstract: OBJECTIVE
  The primary purpose of this study was to compare referral to additional clinical services after primary care clinicians screened for and found a positive screen for alcohol misuse, depression, or posttraumatic stress disorder (PTSD).
  
  
  METHODS
  Results from the Alcohol Use Disorders Identification Test, Patient Health Questionnaire 2, and Primary Care PTSD screens performed over two years at the Philadelphia Veterans Affairs (VA) Medical Center and affiliated VA community sites were analyzed by mixed-effects logistic regression. A total of 9,052 veterans with positive screens were eligible for additional clinical services.
  
  
  RESULTS
  Odds of referral to additional clinical services for positive depression or PTSD screens were significantly higher than for positive screens for alcohol misuse (odds ratio=10.60 and 19.49, respectively).
  
  
  CONCLUSIONS
  Primary care-based screening for alcohol misuse is managed differently than for depression or PTSD.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104, USA. donovan.maust@uphs.upenn.edu
authors.forename: Donovan T
authors.initials: DT
authors.lastname: Maust
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Mavandadi
authors.forename: Johanna
authors.initials: J
authors.lastname: Klaus
authors.forename: David W
authors.initials: DW
authors.lastname: Oslin
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015143:Philadelphia; D011320:Primary Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires