title: Healthcare utilization and symptom variation among veterans using Behavioral Telehealth Center services.
abstract: Substance use and mental health problems are often underdiagnosed and undertreated in primary care. Veterans affairs facilities are using the Behavioral Telehealth Center (BTC) to provide evidence-based assessments for primary care patients via telephone. Whether participation in BTC services is associated with (1) increases in healthcare utilization and (2) decreases in symptoms based on behavioral health screening instruments, post-BTC services compared with pre-BTC services were investigated. Retrospective data were extracted for 1,820 patients who were referred to the BTC. Differences in utilization rates and symptom scores pre- and post-BTC services were tested using repeated measures analysis of covariance while controlling for relevant sociodemographic variables. Participants (1) utilized significantly more substance use and mental health treatment services and (2) had significantly lower alcohol and depression screening scores post-BTC services compared with pre-BTC services. This initial evaluation provides support that BTC services are associated with increased healthcare utilization and decreased alcohol and depressive symptoms.
authors.affiliation: Syracuse Veterans Affairs Medical, Center for Integrated Healthcare, Syracuse, NY 13210, USA. kyle.possemato@va.gov
authors.forename: Kyle
authors.initials: K
authors.lastname: Possemato
authors.forename: Todd M
authors.initials: TM
authors.lastname: Bishop
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Willis
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Lantinga
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation*; D001524:Behavioral Medicine; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D019114:Remote Consultation; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation*; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*