title: Factors Affecting Health Care Utilization in OEF/OIF Veterans: The Impact of PTSD and Pain.
abstract: OBJECTIVE
  Returning Operation Enduring Freedom and Operation Iraqi Freedom veterans are at a high risk for physical and mental health symptoms including pain (90%) and post-traumatic stress disorder (PTSD) (58%). These often present concurrently and result in many health problems, functional impairments, and overall poor rehabilitation. To address postdeployment health, effective and efficient allocation of health care resources is needed.
  
  
  METHODS
  Retrospective study of 144 veterans who completed a second-level screening in the Polytrauma clinic. Veterans completed the PTSD Checklist-Civilian Version. Their pain rating and health care utilization (sum of visits during 12 months, categorized as medical or mental health) was extracted through chart review.
  
  
  RESULTS
  The majority of veterans reported significant PTSD (72%) and pain (87%) symptoms; 45% received adequate mental health treatment, defined as ≥8 sessions in 12 months. PTSD and the interaction with pain predicted medical utilization; at high pain levels veterans' PTSD severity predicted utilization. PTSD alone predicted mental health utilization.
  
  
  CONCLUSIONS
  The results show the increased influence of PTSD symptoms on medical health care services when pain ratings are high and suggest the need for interdisciplinary pain clinics that are able to address the overlapping symptoms of pain and common mental health conditions. Implication of results for VA planning are discussed.
authors.affiliation: Department of Psychology, The University of Memphis, 202 Psychology Building, Memphis, TN 38152.
authors.forename: Katie P
authors.initials: KP
authors.lastname: Lang
authors.affiliation: Department of Psychology, The University of Memphis, 202 Psychology Building, Memphis, TN 38152.
authors.forename: Katherine
authors.initials: K
authors.lastname: Veazey-Morris
authors.affiliation: Department of Psychology, The University of Memphis, 202 Psychology Building, Memphis, TN 38152.
authors.forename: Kristoffer S
authors.initials: KS
authors.lastname: Berlin
authors.affiliation: Department of Psychology, The University of Memphis, 202 Psychology Building, Memphis, TN 38152.
authors.forename: Frank
authors.initials: F
authors.lastname: Andrasik
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000523:psychology*; D010146:Pain / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D014481:United States; D014728:Veterans / Q000523:psychology*