Mental health care integration and primary care patient experience in the Veterans Health Administration

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 100587
Author(s):  
Lucinda B. Leung ◽  
Danielle Rose ◽  
Rong Guo ◽  
Catherine E. Brayton ◽  
Lisa V. Rubenstein ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Patient Experience ◽  
Primary Care Patient ◽  
Veterans Health Administration ◽  
Care Patient ◽  
Veterans Health ◽  
Health Administration ◽  
Care Integration

scholarly journals Predictors of Veterans Health Administration utilization and pain persistence among soldiers treated for postdeployment chronic pain in the Military Health System

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rachel Sayko Adams ◽  
Esther L. Meerwijk ◽  
Mary Jo Larson ◽  
Alex H. S. Harris
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Chronic Pain ◽  
Veterans Health Administration ◽  
First Year ◽  
Veterans Health ◽  
Health Administration ◽  
Military Health System ◽  
Military Health ◽  
The Military

Abstract Background Chronic pain presents a significant burden for both federal health care systems designed to serve combat Veterans in the United States (i.e., the Military Health System [MHS] and Veterans Health Administration [VHA]), yet there have been few studies of Veterans with chronic pain that have integrated data from both systems of care. This study examined 1) health care utilization in VHA as an enrollee (i.e., linkage to VHA) after military separation among soldiers with postdeployment chronic pain identified in the MHS, and predictors of linkage, and 2) persistence of chronic pain among those utilizing the VHA. Methods Observational, longitudinal study of soldiers returning from a deployment in support of the Afghanistan/Iraq conflicts in fiscal years 2008–2014. The analytic sample included 138,206 active duty soldiers for whom linkage to VHA was determined through FY2019. A Cox proportional hazards model was estimated to examine the effects of demographic characteristics, military history, and MHS clinical characteristics on time to linkage to VHA after separation from the military. Among the subpopulation of soldiers who linked to VHA, we described whether they met criteria for chronic pain in the VHA and pain management treatments received during the first year in VHA. Results The majority (79%) of soldiers within the chronic pain cohort linked to VHA after military separation. Significant predictors of VHA linkage included: VHA utilization as a non-enrollee prior to military separation, separating for disability, mental health comorbidities, and being non-Hispanic Black or Hispanic. Soldiers that separated because of misconduct were less likely to link than other soldiers. Soldiers who received nonpharmacological treatments, opioids/tramadol, or mental health treatment in the MHS linked earlier to VHA than soldiers who did not receive these treatments. Among those who enrolled in VHA, during the first year after linking to the VHA, 49.7% of soldiers met criteria for persistent chronic pain in VHA. Conclusions The vast majority of soldiers identified with chronic pain in the MHS utilized care within VHA after military separation. Careful coordination of pain management approaches across the MHS and VHA is required to optimize care for soldiers with chronic pain.

Integrating Physical and Mental Health Care in the Veterans Health Administration

2017 ◽  
Author(s):  
Lisa V. Rubenstein
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Integrated Care ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Physical And Mental Health ◽  
Physical Health Care ◽  
Mental And Physical Health

The Veterans Health Administration, part of the U.S. Department of Veterans Affairs (VA), is responsible for the largest integrated health care system in the United States and is committed historically and by statute to provide mental and physical health care for veterans. The evolution of integrated mental and physical health care in the VA serves as an in-depth, real-world example of large-scale implementation of integrated care models. The VA’s ongoing national primary care/mental health care integration initiative is the foundation for the system’s efforts in this regard. The challenges and opportunities VA implementers faced in promoting integrated mental health care show the feasibility and importance of providing integrated care and the fundamental changes required for achievement. This chapter discusses the drivers and resources, as well as the barriers, involved in the development of an integrated physical and mental health care model.

scholarly journals Veterans Health Administration Investments In Primary Care And Mental Health Integration Improved Care Access

2019 ◽  
Vol 38 (8) ◽  
pp. 1281-1288 ◽  
Author(s):  
Lucinda B. Leung ◽  
Lisa V. Rubenstein ◽  
Jean Yoon ◽  
Edward P. Post ◽  
Erin Jaske ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Care Access ◽  
Mental Health Integration
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