Journal of General Internal Medicine

, Volume 26, Issue 1, pp 33–39 | Cite as

Medical Care Needs of Returning Veterans with PTSD: Their Other Burden

  • Susan M. Frayne
  • Victor Y. Chiu
  • Samina Iqbal
  • Eric A. Berg
  • Kaajal J. Laungani
  • Ruth C. Cronkite
  • Joanne Pavao
  • Rachel Kimerling
Original Research

ABSTRACT

BACKGROUND

There has been considerable focus on the burden of mental illness (including post-traumatic stress disorder, PTSD) in returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans, but little attention to the burden of medical illness in those with PTSD.

OBJECTIVES

(1) Determine whether the burden of medical illness is higher in women and men OEF/OIF veterans with PTSD than in those with No Mental Health Conditions (MHC). (2) Identify conditions common in those with PTSD.

DESIGN

Cross-sectional study using existing databases (Fiscal Year 2006–2007).

SETTING

Veterans Health Administration (VHA) patients nationally.

PATIENTS

All 90,558 OEF/OIF veterans using VHA outpatient care nationally, categorized into strata: PTSD, Stress-Related Disorders, Other MHCs, and No MHC.

MEASUREMENTS

(1) Count of medical conditions; (2) specific medical conditions (from ICD9 codes, using Agency for Health Research and Quality’s Clinical Classifications software framework).

MAIN RESULTS

The median number of medical conditions for women was 7.0 versus 4.5 for those with PTSD versus No MHC (p < 0.001), and for men was 5.0 versus 4.0 (p < 0.001). For PTSD patients, the most frequent conditions among women were lumbosacral spine disorders, headache, and lower extremity joint disorders, and among men were lumbosacral spine disorders, lower extremity joint disorders, and hearing problems. These high frequency conditions were more common in those with PTSD than in those with No MHC.

CONCLUSIONS

Burden of medical illness is greater in women and men OEF/OIF veteran VHA users with PTSD than in those with No MHC. Health delivery systems serving them should align clinical program development with their medical care needs.

KEY WORDS

stress disorders post-traumatic veterans Afghan campaign 2001- Iraq War 2003- women 

Supplementary material

11606_2010_1497_MOESM1_ESM.pdf (54 kb)
Appendix 1Mental Health Condition Specifications (PDF 54.4 KB)
11606_2010_1497_MOESM2_ESM.pdf (485 kb)
Appendix 2Gender-stratified Frequency of all 222 Medical Conditions, by PTSD Status, in OEF/OIF Veterans Health Administration Patients; Frequency Rank for Women and Men with PTSD (with 1 indicating most frequent); and Age-Adjusted Odds Ratio (PTSD vs No MHC)* (PDF 484 KB)
11606_2010_1497_MOESM3_ESM.pdf (296 kb)
Appendix 3Cumulative Medical Condition Count by PTSD Status by Gender, Sensitivity Analysis 1-4, truncated at 25 conditions. (PDF 295 KB)
11606_2010_1497_MOESM4_ESM.pdf (119 kb)
Appendix 4Definition of VA Outpatient Face-to-Face Visits (Technical specifications: clinic “stop” codes used to define face-to-face visits.) (PDF 118 KB)
11606_2010_1497_MOESM5_ESM.pdf (13 kb)
Appendix 5Definition of Primary Care Clinic Stops. (Technical specifications: Clinic stop codes used to define primary care encounters.) (PDF 13.2 KB)

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Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Susan M. Frayne
    • 1
    • 2
    • 3
    • 4
  • Victor Y. Chiu
    • 1
  • Samina Iqbal
    • 2
    • 4
  • Eric A. Berg
    • 1
    • 2
  • Kaajal J. Laungani
    • 1
  • Ruth C. Cronkite
    • 1
    • 3
    • 5
  • Joanne Pavao
    • 6
  • Rachel Kimerling
    • 1
    • 4
    • 6
  1. 1.Center for Health Care Evaluation, VA Palo Alto Health Care SystemMenlo ParkUSA
  2. 2.Division of General Internal Medicine, Stanford UniversityStanfordUSA
  3. 3.Center for Primary Care and Outcomes Research, Stanford UniversityStanfordUSA
  4. 4.Center of Excellence in Women’s Health , VA Palo Alto Health Care SystemPalo AltoUSA
  5. 5.Department of Sociology, Stanford UniversityStanfordUSA
  6. 6.National Center for PTSD, VA Palo Alto Health Care SystemMenlo ParkUSA

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