Mental and physical health factors related to dual use of veterans affairs and non-veterans affairs healthcare among U.S. reserve soldiers

ABSTRACT

This study examined the association between mental and physical health factors and dual use of Veterans’ Affairs (VA) and non-VA healthcare among previously deployed male Reserve/National Guard (R/NG) soldiers (N = 214). Participants completed online annual surveys on a range of topics, including validated measures of mental and physical health, as well as questions about past-year healthcare utilization. Multinomial logistic regression models separately examined the association between mental health symptoms (PTSD, anxiety, depression, emotional role limitations), physical health symptoms (bodily pain, physical role limitations), and healthcare use (single use and dual use compared to no use), controlling for geography, trust in the VA, age, and race. Anxiety (aRR: 1.13; 95% Confidence Interval (CI): 1.02, 1.26; p<.05), depression (aRR: 1.23; 95% CI: 1.06, 1.43; p<.01), and PTSD (aRR: 1.05; 95% CI: 1.01, 1.10; p<.05) symptoms were all related to past year dual use of VA and non-VA healthcare, even after controlling for known demographic factors. Bodily pain and emotional and physical role limitations were not related to healthcare outcomes. This suggests that mental health symptoms themselves may be a primary factor driving healthcare use. Further study is needed to examine whether dual use of VA and non-VA healthcare is duplicative or complementary.

KEYWORDS:

• Healthcare utilization
• veterans
• mental health
• physical health

Acknowledgments

Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under award number R01DA034072 (GGH) and the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001412. Dr. Kulak and Dr. Hoopsick’s time was supported through Health Resources and Services Administration (HRSA) award #T32HP30035 to the University at Buffalo Primary Care Research Institute (PI: Kahn). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Portions of this work were presented as a poster at the Translational Science Meeting (Association of Clinical and Translational Science), April 19-21, 2018. Washington, DC.

Disclosure statement

The authors assert that they have no conflicts of interest, financial or otherwise, to disclose.

Additional information

Funding

This work was supported by the Health Resources and Services Administration [T32HP30035]; National Center for Advancing Translational Sciences [UL1TR001412]; National Institute on Drug Abuse [R01DA034072].