What question did this study set out to answer?

To evaluate patterns of healthcare service utilization across general primary care, specialized primary care, medical specialties, and mental health services among veterans at high risk of near-term hospitalization.

June 29, 2020JAMA Network OpenOpen Access

Use of General Primary Care, Specialized Primary Care, and Other Veterans Affairs Services Among High-Risk Veterans

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To evaluate patterns of healthcare service utilization across general primary care, specialized primary care, medical specialties, and mental health services among veterans at high risk of near-term hospitalization.
National, retrospective cross-sectional study of 4,309,192 veterans enrolled in Veterans Health Administration primary care as of September 30, 2015.
Identified high-risk veterans (n = 351,012) using a validated risk prediction model designating the top 5% risk of near-term hospitalization, and examined encounter counts across multiple clinical settings.
Most high-risk veterans were managed in general primary care (88% [n = 308,433]) rather than specialized primary care clinics (12% [n = 42,579]).
High-risk patients in general primary care had more primary care visits (mean 6.9 vs 6.3 per year; P < .001) and medical specialty visits (mean 4.4 vs 3.7 per year; P < .001), but fewer mental health visits (mean 9.0 vs 11.3 per year; P < .001) than those in specialized clinics.
High hospitalization risk was strongly associated with psychiatric and medical comorbidities, including schizophrenia (OR 5.14, 95% CI 5.05-5.22) and alcohol abuse (OR 4.54, 95% CI 4.50-4.59), while use of intensive outpatient services remained low overall.

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Implication

Retrospective cross-sectional study finds high-risk veterans predominantly receive care in general primary clinics, suggesting interventions should be embedded in general and mental healthcare.

Cite This Study

Chang et al. (2020) studied this question.

synapsesocial.com/papers/6a1aa1ad7ff99bba0645f7ff https://doi.org/10.1001/jamanetworkopen.2020.8120

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Implication

Retrospective cross-sectional study finds high-risk veterans predominantly receive care in general primary clinics, suggesting interventions should be embedded in general and mental healthcare.

Use of General Primary Care, Specialized Primary Care, and Other Veterans Affairs Services Among High-Risk Veterans

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Discussion

Implication

Cite This Study

Use of General Primary Care, Specialized Primary Care, and Other Veterans Affairs Services Among High-Risk Veterans

Key Points

Discussion

Implication

Cite This Study

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