Impact of Treatment Duration on Mortality Among Veterans with Opioid Use Disorder in the United States Veterans Health Administration

Addiction ◽  
2021 ◽  
Author(s):  
Jack H. Ching ◽  
Douglas K. Owens ◽  
Jodie A. Trafton ◽  
Jeremy D. Goldhaber‐Fiebert ◽  
Joshua A. Salomon
Keyword(s):  
United States ◽  
Treatment Duration ◽  
Veterans Health Administration ◽  
The United States ◽  
Opioid Use Disorder ◽  
Veterans Health ◽  
Health Administration ◽  
Opioid Use

Sex Differences in Opioid Use Disorder Prevalence and Multimorbidity Nationally in the Veterans Health Administration

2021 ◽  
pp. 1-11
Author(s):  
MacKenzie R. Peltier ◽  
Mehmet Sofuoglu ◽  
Ismene L. Petrakis ◽  
Elina Stefanovics ◽  
Robert A. Rosenheck
Keyword(s):  
Sex Differences ◽  
Veterans Health Administration ◽  
Opioid Use Disorder ◽  
Veterans Health ◽  
Health Administration ◽  
Opioid Use

Transformation of the US Veterans Health Administration

2006 ◽  
Vol 1 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Jonathan B. Perlin
Keyword(s):  
United States ◽  
Health Care ◽  
Veterans Health Administration ◽  
The United States ◽  
Veterans Affairs ◽  
United States Department ◽  
Veterans Health ◽  
Department Of Veterans Affairs ◽  
Health Administration ◽  
The Us

Ten years ago, it would have been hard to imagine the publication of an issue of a scholarly journal dedicated to applying lessons from the transformation of the United States Department of Veterans Affairs Health System to the renewal of other countries' national health systems. Yet, with the recent publication of a dedicated edition of the Canadian journal Healthcare Papers (2005), this actually happened. Veterans Affairs health care also has been similarly lauded this past year in the lay press, being described as ‘the best care anywhere’ in the Washington Monthly, and described as ‘top-notch healthcare’ in US News and World Report's annual health care issue enumerating the ‘Top 100 Hospitals’ in the United States (Longman, 2005; Gearon, 2005).

scholarly journals Implementation evaluation of academic detailing on naloxone prescribing trends at the United States Veterans Health Administration

2019 ◽  
Vol 54 (5) ◽  
pp. 1055-1064 ◽  
Author(s):  
Mark Bounthavong ◽  
Emily Beth Devine ◽  
Melissa L. D. Christopher ◽  
Michael A. Harvey ◽  
David L. Veenstra ◽  
...  
Keyword(s):  
United States ◽  
Veterans Health Administration ◽  
The United States ◽  
Veterans Health ◽  
Academic Detailing ◽  
Health Administration ◽  
Implementation Evaluation ◽  
Prescribing Trends

Cataract surgery practice patterns in the United States Veterans Health Administration

2012 ◽  
Vol 38 (4) ◽  
pp. 705-709 ◽  
Author(s):  
Paul B. Greenberg ◽  
Annika Havnaer ◽  
Thomas A. Oetting ◽  
Francisco J. Garcia-Ferrer
Keyword(s):  
United States ◽  
Cataract Surgery ◽  
Practice Patterns ◽  
Veterans Health Administration ◽  
The United States ◽  
Veterans Health ◽  
Health Administration

scholarly journals 1164. County-Level Geographic Distribution of Extended-Spectrum Cephalosporin-Resistant Enterobacteriaceae Across Outpatient Settings of the Veterans Health Administration, 2000–2017

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S350-S351
Author(s):  
Michihiko Goto ◽  
Rajeshwari Nair ◽  
Daniel Livorsi ◽  
Marin Schweizer ◽  
Michael Ohl ◽  
...  
Keyword(s):  
United States ◽  
Veterans Health Administration ◽  
The United States ◽  
Incidence Rates ◽  
County Level ◽  
Veterans Health ◽  
Health Administration ◽  
Geographic Variability ◽  
Extended Spectrum ◽  
Outpatient Settings

Abstract Background Extended-spectrum cephalosporin resistance (ESCR) among Enterobacteriaceae has emerged globally over the last two decades, with increased prevalence in the community. Data from European countries and healthcare-associated isolates in the United States have demonstrated substantial geographic variability in the prevalence of ESCR, but community-onset isolates in the United States have been less studied. We aimed to describe geographic distribution and spread of ESCR among outpatient settings across the Veterans Health Administration (VHA) over 18 years. Methods We analyzed a retrospective cohort of all patients who had any positive clinical culture specimen for ESCR Enterobacteriaceae collected in an outpatient setting; ESCR was defined by phenotypic nonsusceptibility to at least one extended-spectrum cephalosporin agent or detection of an extended-spectrum β-lactamase. Patient-level data were grouped by county of residence, and the total number of unique patients who received care within VHA for each county was used as a denominator. We aggregated data by time terciles (2000–2005, 2006–2011, and 2012–2017), and overall and county-level incidence rates were calculated as the number of unique patients in each year with ESCR Enterobacteriaceae per person-year. Results During the study period, there were 1,980,095 positive cultures for Enterobacteriaceae from 870,797 unique patients across outpatient settings of VHA, from a total of 107,404,504 person-years. Among those, 136,185 cultures (6.9%) from 75,500 unique patients (8.7%) were ESCR. The overall incidence rate was 9.0 cases per 10,000 person-years, which increased from 6.3 per 10,000 person-years in 2000 to 14.6 per 10,000 person-years in 2017. County-level incidence rates ranged widely but increased overall (interquartile range [IQR] in 2000–2005: 0–6.7; 2006–2011: 0–9.1; 2012–2017: 3.1–14.3 per 10,000 person-years), with some geographic clustering (figure). Conclusion This study demonstrates that there has been geographic variation both in incidence rates and trends of ESCR Enterobacteriaceae in outpatient settings of VHA, which suggests the importance of tailoring local antibiotic-prescribing guidelines incorporating geographic variability in epidemiology. Disclosures M. Ohl, Gilead Sciences, Inc.: Grant Investigator, Research grant.

Opioid use disorder and homelessness in the Veterans Health Administration: The challenge of multimorbidity

2018 ◽  
Vol 14 (3) ◽  
pp. 171-182 ◽  
Author(s):  
Theddeus Iheanacho, MD ◽  
Elina Stefanovics, PhD ◽  
Robert Rosenheck, MD
Keyword(s):  
Risk Factor ◽  
Service Use ◽  
Veterans Health Administration ◽  
Opioid Use Disorder ◽  
Fiscal Year ◽  
Veterans Health ◽  
Health Administration ◽  
Opioid Use ◽  
Agonist Therapy ◽  
Homeless Veterans

Objective: The aim of this study is to estimate the prevalence and sociodemographic and clinical correlates of opioid use disorder (OUD), a major cause of morbidity and mortality in the United States, among homeless veterans nationally in the Veterans Health Administration (VHA).Design: Administrative data on 256,404 veterans who were homeless and/or had OUD in fiscal year 2012 were analyzed to evaluate OUD as a risk factor for homelessness along with associated characteristics, comorbidities, and patterns of service use. Bivariate analyses and logistic regression were used to compare homeless veterans with OUD to veterans with OUD but no homelessness and homeless veterans with no OUD.Results: Altogether 17.9 percent of homeless VHA users were diagnosed with OUD and 34.6 percent of veterans with OUD were homeless. The risk ratio (RR) for homelessness among veterans with OUD was 28.7. Homeless veterans with OUD, compared to nonhomeless veterans with OUD showed extensive multimorbidity with greater risk for HIV (RR = 1.57), schizophrenia (RR = 1.62), alcohol use disorder (RR = 1.67), and others. Homeless veterans with OUD also showed more multimorbidity and used more services than homeless veterans without OUD. Homeless and nonhomeless OUD veterans used opiate agonist therapy at similar, but very low rates (13 and 15 percent).Conclusions: OUD is a major risk factor for homelessness. Homeless veterans with OUD have high levels of multimorbidity and greater service use than veterans with either condition alone. Tailored, facilitated access to opioid agonist therapy may improve outcomes for these vulnerable veterans.

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