title: Outpatient health care utilization in a sample of cognitively impaired veterans receiving care in VHA geriatric evaluation and management clinics.
abstract: Within the Veterans Health Administration (VHA), Geriatric Evaluation And Management (GEM) clinics are designed specifically to address the needs of older veterans with complex age-related concerns, including dementia and comorbid medical and mental health conditions. Previous literature describes aging veterans as having greater health care needs compared with age-matched nonveteran samples, and multimorbidity is of particular concern in this population. Using data extracted from electronic medical records (EMRs), the present study describes the demographic characteristics, mental health diagnoses, and health care utilization of a sample of 476 VHA GEM patients with diagnosed cognitive impairment or dementia seen in clinics across Upstate New York. Examination of EMR data demonstrated that in addition to diagnosed cognitive impairment and dementia, over 66% of the sample had at least 1 additional mental health diagnosis coded during the study period. Many were prescribed dementia medications and/or other psychotropic medications, predominantly antidepressants. These veterans utilized a variety of outpatient services, including high rates of mental health consultation subsequent to GEM evaluation, though low rates of mental health follow-up were observed. Results from the current study provide insight into the important role mental health providers such as psychologists and psychiatrists can play as collaborators in interdisciplinary geriatrics care for veterans.
authors.affiliation: VA Center for Integrated Healthcare.
authors.forename: Paul R
authors.initials: PR
authors.lastname: King
authors.affiliation: VA Center for Integrated Healthcare.
authors.forename: Christina L
authors.initials: CL
authors.lastname: Vair
authors.affiliation: Department of Psychology, VA Center for Integrated Healthcare.
authors.forename: Michael
authors.initials: M
authors.lastname: Wade
authors.affiliation: VA Center for Integrated Healthcare.
authors.forename: Julie
authors.initials: J
authors.lastname: Gass
authors.affiliation: VA Center for Integrated Healthcare.
authors.forename: Laura O
authors.initials: LO
authors.lastname: Wray
authors.affiliation: VA Western New York Healthcare System.
authors.forename: Anna
authors.initials: A
authors.lastname: Kusche
authors.affiliation: VA Western New York Healthcare System.
authors.forename: Charito
authors.initials: C
authors.lastname: Saludades
authors.affiliation: VA Western New York Healthcare System.
authors.forename: June
authors.initials: J
authors.lastname: Chang
mesh_terms: D000275:Adjustment Disorders / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000453:epidemiology; D000544:Alzheimer Disease / Q000453:epidemiology; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001008:Anxiety Disorders / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology*; D015140:Dementia, Vascular / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology; D057286:Electronic Health Records; D005260:Female; D015577:Geriatric Assessment; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*