title: Healthcare utilization following mild traumatic brain injury in female veterans.
abstract: BACKGROUND
  Mild traumatic brain injury (TBI) is a significant problem for Veterans. Gender differences in mild TBI outcomes such as return-to-work, resolution of symptoms and mental health diagnoses have been reported. The purpose of the study is to characterize gender differences in VA healthcare utilization in the year following mild TBI diagnosis.
  
  
  METHODS
  This was a retrospective database study of 12 144 Veterans diagnosed with mild TBI in fiscal year 2008 and their healthcare utilization in the following year.
  
  
  RESULTS
  The mean age was 43.6 ± 17 and the majority were men (94.1%). Overall, women had more outpatient utilization than men with mild TBI (mean: 48 vs. 37 visits; p ≤ 0.001). Adjusted analyses indicated that women had a rate of outpatient utilization 25% higher than men (IRR = 1.25, 95% CI = 1.17-1.33). It was found that 13.6% of the difference in outpatient utilization by gender could be explained by other factors such as race, age, marital status, geographic location and illness burden.
  
  
  CONCLUSIONS
  Male Veterans had less outpatient utilization than females in the year following mild TBI diagnosis. Gender and other factors only accounted for a small portion of the differences observed; therefore, gender only partially accounts for differences in healthcare utilization following mild TBI.
authors.affiliation: Department of Veterans Affairs (VA), Center for Management of Complex Chronic Care (CMC3) .
authors.forename: Thea J
authors.initials: TJ
authors.lastname: Rogers
authors.forename: Bridget M
authors.initials: BM
authors.lastname: Smith
authors.forename: Frances M
authors.initials: FM
authors.lastname: Weaver
authors.forename: Shanti
authors.initials: S
authors.lastname: Ganesh
authors.forename: Karen L
authors.initials: KL
authors.lastname: Saban
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Stroupe
authors.forename: Rachael N
authors.initials: RN
authors.lastname: Martinez
authors.forename: Charlesnika T
authors.initials: CT
authors.lastname: Evans
authors.forename: Theresa L-B
authors.initials: TL
authors.lastname: Pape
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001753:Blast Injuries / Q000453:epidemiology; D001930:Brain Injuries / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D062707:Return to Work / Q000523:psychology / Q000706:statistics & numerical data*; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*; D016387:Women's Health
keywords: Administrative data; healthcare utilization; traumatic brain injury; women veterans