Healthcare Utilization and Symptom Variation Among Veterans Using Behavioral Telehealth Center Services
- 436 Downloads
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.
KeywordsBehavioral Health Veteran Health Administration Healthcare Utilization Primary Care Patient Alcohol Misuse
Conflict of Interest Statement
The authors do not have financial or any other conflicts of interest regarding the contents of this manuscript.
- 2.National Ambulatory Medical Survey 2008 Survey Tables; Center for Disease Control, Mental Health Work Group, Atlanta, Ga. 30341–3717.Google Scholar
- 5.Murray C, Lopez A. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Boston: Harvard University Press, 1996.Google Scholar
- 14.Weathers F, Ford J. Psychometric review of the PTSD Checklist. In: Stamm B, editor. Measurement of stress, trauma, and adaptation. Lutherville, MD: Sidran Press, 1996. pp. 250–251.Google Scholar
- 15.PTSD Checklist (PCL). National Center for PTSD. Available at: http://www.ptsd.va.gov/professional/pages/assessments/ptsd-checklist.asp. Accessed 20 December 2011.
- 17.National Institute on Alcoholism and Alcohol Abuse. Helping Patients Who Drink Too Much, A Clinician’s Guide: Updated 2005 Edition (NIH Publication No. 07–3769). Washington, DC: Government Printing Office. 2007.Google Scholar
- 19.Ware JE, Kosinski M, Turner-Bowker DM, et al. How to Score Version 2 of the SF-12 Health Survey. Lincoln, RI: Quality Metric Incorporated. 2002.Google Scholar
- 22.Alegría M, Canino G, Ríos R, et al. Inequalities in use of specialty mental health services among Latinos, African Americans, and non-Latino whites. Psychiatric Services 2007; 15:1547–1555.Google Scholar
- 24.Veterans Affairs/Department of Defense (VA/DoD). Acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) in primary care. In: VA/DOD clinical practice guideline for the management of post-traumatic stress (Module B). 2004. Available at: http://www.healthquality.va.gov/ptsd/ptsd_full.pdf