Health care cost trajectories in the year prior to and following intake into Veterans Health Administration outpatient substance use disorders treatment

2017 ◽  
Vol 79 ◽  
pp. 46-52
Author(s):  
Hildi J. Hagedorn ◽  
Siamak Noorbaloochi ◽  
Ann Bangerter ◽  
Maxine L. Stitzer ◽  
Daniel Kivlahan
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Health Care Cost ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration

scholarly journals 168. Testing, Diagnosis, and Incidence of Sexually Transmitted Infections Among People with Substance Use Disorders in the Veterans Health Administration, 2019

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S101-S101
Author(s):  
Holly Villamagna ◽  
Lauren Beste ◽  
Joleen Borgerding ◽  
Elliott Lowy ◽  
Ronald Hauser ◽  
...  
Keyword(s):  
Substance Use ◽  
Sexually Transmitted Infections ◽  
Substance Use Disorders ◽  
Veterans Health Administration ◽  
Incidence Rates ◽  
Veterans Health ◽  
Health Administration ◽  
Sexually Transmitted ◽  
Stimulant Use ◽  
Sti Testing

Abstract Background People with substance use disorders (SUDs) are at increased risk of acquiring sexually transmitted infections (STIs.) In response to the syndemic of STIs and SUDs, the Department of Health and Human Services’ 2020 STI National Strategic Plan called for increased STI testing among people with SUDs and integration of testing and treatment into non-traditional settings. Existing data describing STI testing and incidence rates among people with SUDs are limited to single or regional medical centers. National samples are needed to target interventions. We report on STI testing, test positivity, and incidence rates among people with SUDs who receive medical care in the Veterans Health Administration (VHA). Methods We performed a retrospective cohort study of individuals with SUDs who received VHA care in 2018 or 2019. Data were obtained from the Corporate Data Warehouse, a national database that includes data from VHA’s electronic medical record. For individuals with alcohol, opioid, cocaine, and/or other stimulant (e.g. methamphetamine) use disorders, we collected demographic data, testing and results for gonorrhea (GC), chlamydia (CT), syphilis, and HIV during 2019. We calculated rates of testing, test positivity, and incidence rates. Results Incidence of all four STIs was highest in the other stimulant use disorder group; incidence of syphilis was particularly elevated at 922.4 cases/100K. Veterans with multiple SUDs were three times more likely to be houseless in 2019 than those with a single SUD and had higher incidence of all STIs than those with single SUDs, except for people with other stimulant use disorders. People with alcohol use disorder (AUD) had a higher incidence of GC, CT, and syphilis than those with opioid use disorder despite similar testing rates. Percent positivity for HIV ranged from 0.27% for AUD to 2.0% for other stimulant use disorders. Conclusion High incidence of STIs among people with non-cocaine stimulant use disorder indicates a need for comprehensive testing. The data suggests that veterans with AUD would benefit from increased testing. Houselessness and mental health diagnoses were common, and comprehensive STI testing and treatment programs, including an assessment of HIV risk, should be integrated into programs addressing these comorbidities. Disclosures Holly Villamagna, MD, Nothing to disclose

scholarly journals Substance use disorders and the risk of suicide mortality among men and women in the US Veterans Health Administration

Addiction ◽  
2017 ◽  
Vol 112 (7) ◽  
pp. 1193-1201 ◽  
Author(s):  
Kipling M. Bohnert ◽  
Mark A. Ilgen ◽  
Samantha Louzon ◽  
John F. McCarthy ◽  
Ira R. Katz
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Veterans Health Administration ◽  
Suicide Mortality ◽  
Veterans Health ◽  
Health Administration ◽  
Men And Women ◽  
The Us ◽  
Us Veterans

scholarly journals Sex Differences in Mental Health and Substance Use Disorders and Treatment Entry Among Justice-involved Veterans in the Veterans Health Administration

Medical Care ◽  
2015 ◽  
Vol 53 ◽  
pp. S105-S111 ◽  
Author(s):  
Andrea K. Finlay ◽  
Ingrid A. Binswanger ◽  
David Smelson ◽  
Leon Sawh ◽  
Jim McGuire ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Sex Differences ◽  
Substance Use Disorders ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Treatment Entry

scholarly journals Development of Predictive Informatics Tool Using Electronic Health Records to Inform Personalized Evidence-Based Pressure Injury Management for Veterans with Spinal Cord Injury

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 651-658
Author(s):  
Kath M Bogie ◽  
Steven K Roggenkamp ◽  
Ningzhou Zeng ◽  
Jacinta M Seton ◽  
Katelyn R Schwartz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
User Interface ◽  
Veterans Health Administration ◽  
Study Cohort ◽  
Veterans Health ◽  
Health Administration ◽  
Cord Injury

ABSTRACT Background Pressure injuries (PrI) are serious complications for many with spinal cord injury (SCI), significantly burdening health care systems, in particular the Veterans Health Administration. Clinical practice guidelines (CPG) provide recommendations. However, many risk factors span multiple domains. Effective prioritization of CPG recommendations has been identified as a need. Bioinformatics facilitates clinical decision support for complex challenges. The Veteran’s Administration Informatics and Computing Infrastructure provides access to electronic health record (EHR) data for all Veterans Health Administration health care encounters. The overall study objective was to expand our prototype structural model of environmental, social, and clinical factors and develop the foundation for resource which will provide weighted systemic insight into PrI risk in veterans with SCI. Methods The SCI PrI Resource (SCI-PIR) includes three integrated modules: (1) the SCIPUDSphere multidomain database of veterans’ EHR data extracted from October 2010 to September 2015 for ICD-9-CM coding consistency together with tissue health profiles, (2) the Spinal Cord Injury Pressure Ulcer and Deep Tissue Injury Ontology (SCIPUDO) developed from the cohort’s free text clinical note (Text Integration Utility) notes, and (3) the clinical user interface for direct SCI-PIR query. Results The SCI-PIR contains relevant EHR data for a study cohort of 36,626 veterans with SCI, representing 10% to 14% of the U.S. population with SCI. Extracted datasets include SCI diagnostics, demographics, comorbidities, rurality, medications, and laboratory tests. Many terminology variations for non-coded input data were found. SCIPUDO facilitates robust information extraction from over six million Text Integration Utility notes annually for the study cohort. Visual widgets in the clinical user interface can be directly populated with SCIPUDO terms, allowing patient-specific query construction. Conclusion The SCI-PIR contains valuable clinical data based on CPG-identified risk factors, providing a basis for personalized PrI risk management following SCI. Understanding the relative impact of risk factors supports PrI management for veterans with SCI. Personalized interactive programs can enhance best practices by decreasing both initial PrI formation and readmission rates due to PrI recurrence for veterans with SCI.

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