Self-reported physical functioning, cardiometabolic health conditions, and health care utilization patterns in Million Veteran Program enrollees with Traumatic Brain Injury Screening and Evaluation Program data

Background Examining the health outcomes of veterans who have completed the United States Veterans Health Administration’s (VHA’s) Traumatic Brain Injury (TBI) Screening and Evaluation Program may aid in the refinement and improvement of clinical care initiatives within the VHA. This study compared...
Ausführliche Beschreibung

Background Examining the health outcomes of veterans who have completed the United States Veterans Health Administration’s (VHA’s) Traumatic Brain Injury (TBI) Screening and Evaluation Program may aid in the refinement and improvement of clinical care initiatives within the VHA. This study compared self-reported physical functioning, cardiometabolic health conditions, and health care utilization patterns in Million Veteran Program enrollees with TBI Screening and Evaluation Program data (collected between 2007 and 2019), with the goal of enhancing understanding of potentially modifiable health conditions in this population. Methods In this observational cohort study, veterans (n = 16,452) were grouped based on the diagnostic outcome of the TBI Screening and Evaluation Program: 1) negative TBI screen ($ Screen^{–} $); 2) positive TBI screen but no confirmed TBI diagnosis [$ Screen^{+} $/ Comprehensive TBI Evaluation (CTBIE)–]; or 3) positive TBI screen and confirmed TBI diagnosis ($ Screen^{+} $/$ CTBIE^{+} $). Chi-square tests and analysis of covariance were used to explore group differences in physical functioning, cardiometabolic health conditions, and health care utilization patterns, and logistic regressions were used to examine predictors of $ Screen^{+/–} $ and $ CTBIE^{+/–} $ group status. Results The results showed that veterans in the $ Screen^{+} $/$ CTBIE^{–} $ and $ Screen^{+} $/$ CTBIE^{+} $ groups generally reported poorer levels of physical functioning (P’s < 0.001, np2 = 0.02 to 0.03), higher rates of cardiometabolic health conditions (P’s < 0.001, φ = 0.14 to 0.52), and increased health care utilization (P’s < 0.001, φ = 0.14 to > 0.5) compared with the $ Screen^{–} $ group; however, health outcomes were generally comparable between the $ Screen^{+} $/$ CTBIE^{–} $ and $ Screen^{+} $/$ CTBIE^{+} $ groups. Follow-up analyses confirmed that while physical functioning, hypertension, stroke, healthcare utilization, and prescription medication use reliably distinguished between the $ Screen^{–} $ and $ Screen^{+} $ groups (P’s < 0.02, OR’s 0.78 to 3.38), only physical functioning distinguished between the $ Screen^{+} $/$ CTBIE^{–} $ and $ Screen^{+} $/$ CTBIE^{+} $ groups (P < 0.001, OR 0.99). Conclusions The findings suggest that veterans who screen positive for TBI, regardless of whether they are ultimately diagnosed with TBI, are at greater risk for negative health outcomes, signifying that these veterans represent a vulnerable group that may benefit from increased clinical care and prevention efforts. Ausführliche Beschreibung

Autor*in:	Clark, Alexandra L. [verfasserIn] McGill, Makenna B. Ozturk, Erin D. Schnyer, David M. Chanfreau-Coffinier, Catherine Merritt, Victoria C.

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Traumatic brain injury (TBI) screen CTBIE Health outcomes Cardiometabolic health Veterans Million Veteran Program (MVP)

Anmerkung:	© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2023

Übergeordnetes Werk:	Enthalten in: Military medical research - London : BioMed Central, 2014, 10(2023), 1 vom: 03. Jan.
Übergeordnetes Werk:	volume:10 ; year:2023 ; number:1 ; day:03 ; month:01

Links:	Volltext

DOI / URN:	10.1186/s40779-022-00435-7

Katalog-ID:	SPR051308916