Prevalence of gastrointestinal disease in US Military Veterans under outpatient care at the Veterans Health Administration

Objectives: There are currently no reliable estimates of the prevalence of gastrointestinal disease in the US Military Veterans. Hence, the study aims to determine its prevalence in military Veterans in the United States. Methods: This study utilized a retrospective, correlational design using a patient record database from the Department of Veteran’s Affairs. The participants in the study were Veterans diagnosed with gastrointestinal disease. Specific gastrointestinal diseases include more than 500,000 ambulatory care visits annually in the United States, which included peptic ulcer disease, gastroesophageal reflux disease, diverticular disease, ulcerative colitis, Crohn’s disease, irritable bowel syndrome, and functional dyspepsia, as well as the symptoms of constipation and nausea/vomiting. This study revealed the exact prevalence of gastrointestinal disease diagnosed in Veterans served in outpatient settings by the Veterans Health Administration and broke down this prevalence over time and by the Veteran period of service. Results: Findings revealed that gastrointestinal disease prevalence among Veterans varied according to their period of service. Conclusions: Findings may help improve screening for Veterans with this increased risk factor. However, further research should be performed to verify the prevalence of gastrointestinal disease in Veterans as compared to the general American population.

Download Full-text

Transformation of the US Veterans Health Administration

Health Economics Policy and Law ◽

10.1017/s1744133105001222 ◽

2006 ◽

Vol 1 (2) ◽

pp. 99-105 ◽

Cited By ~ 12

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).

Download Full-text

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

Health Services Research ◽

10.1111/1475-6773.13194 ◽

2019 ◽

Vol 54 (5) ◽

pp. 1055-1064 ◽

Cited By ~ 8

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

Download Full-text

Cataract surgery practice patterns in the United States Veterans Health Administration

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2012.01.023 ◽

2012 ◽

Vol 38 (4) ◽

pp. 705-709 ◽

Cited By ~ 10

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

Download Full-text

Evaluation of fidaxomicin usage patterns and outcomes forClostridium difficileinfection across the United States Veterans Health Administration

Journal of Clinical Pharmacy and Therapeutics ◽

10.1111/jcpt.12663 ◽

2018 ◽

Vol 43 (3) ◽

pp. 353-358 ◽

Cited By ~ 2

Author(s):

S. E. Giancola ◽

R. J. Williams ◽

C. A. Gentry

Keyword(s):

United States ◽

Veterans Health Administration ◽

The United States ◽

Veterans Health ◽

Health Administration ◽

Usage Patterns

Download Full-text

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

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.997 ◽

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.

Download Full-text