title: Determinants of utilization and cost of VHA care by OEF/OIF Veterans screened for mild traumatic brain injury.
abstract: OBJECTIVE
  To determine the demographic and service characteristics that differentially impact utilization and cost of Veterans Health Administration (VHA) services for Operation Enduring Freedom and Operation Iraq Freedom (OEF/OIF) Veterans screened or evaluated for traumatic brain injury (TBI).
  
  
  METHODS
  We examined Department of Defense (DoD) and VHA administrative records of OEF/OIF Veterans who were screened or evaluated for TBI.
  
  
  METHODS
  Our study population was OEF/OIF Veterans who separated from DoD in Fiscal Years 2003-2009 and who were screened or evaluated in VHA for TBI between October 2008 and July 2009.
  
  
  METHODS
  We describe the demographics and service characteristics of separated Veterans and those who accessed the VHA. We report the cost of VHA utilization and estimate a probit regression model to assess determinants of VHA utilization and costs by OEF/OIF Veterans screened and evaluated for TBI by VHA.
  
  
  RESULTS
  Females and Veterans older than 37 years utilize VHA services more intensely. Across all services, the Reserve Components utilize health services more than the Active Components placing more demand on VHA for services.
  
  
  CONCLUSIONS
  VHA utilization and costs is impacted by the demographic and service characteristics of Veterans. The variation in Veteran groups incurring higher costs and utilization indicates different usage patterns of VHA services by each group with implications for patient load as the DoD deploys higher numbers of females and the Reserve Components.
authors.affiliation: Defense Resources Management Institute, Naval Postgraduate School, 699 Dyer Road, 205A Halligan Hall, Monterey, CA 93943.
authors.forename: Jomana
authors.initials: J
authors.lastname: Amara
authors.affiliation: Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, 150 South Huntington Avenue, Jamaica Plain, MA 02130.
authors.forename: Terri K
authors.initials: TK
authors.lastname: Pogoda
authors.affiliation: Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, 150 South Huntington Avenue, Jamaica Plain, MA 02130.
authors.forename: Maxine
authors.initials: M
authors.lastname: Krengel
authors.affiliation: National Center for PTSD, VA Boston Health Care System and Boston University School of Medicine, 150 South Huntington Avenue (116B-3), Jamaica Plain, MA 02130.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Iverson
authors.affiliation: Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, 150 South Huntington Avenue, Jamaica Plain, MA 02130.
authors.forename: Errol
authors.initials: E
authors.lastname: Baker
authors.affiliation: 29 Pond Street, Hopkinton, MA 01748.
authors.forename: Ann
authors.initials: A
authors.lastname: Hendricks
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000191:economics* / Q000453:epidemiology*; D003710:Demography; D005260:Female; D006787:Hospitals, Veterans / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008403:Mass Screening / Q000191:economics*; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans