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Title: Characteristics of Veterans With Depression Who Use the Veterans Choice Program of the Veterans Health Administration

Journal Article · · Psychiatric Services
 [1];  [2];  [2]; ORCiD logo [3];  [2];  [4];  [2]
  1. Meadows Mental Health Policy Institute, Dallas, TX (United States); Northwestern Univ., Chicago, IL (United States). Feinberg School of Medicine
  2. United States Department of Veterans Affairs (VA), Seattle, WA (United States). VA Puget Sound Healthcare System
  3. Los Alamos National Laboratory (LANL), Los Alamos, NM (United States)
  4. Univ. of Washington, Seattle, WA (United States)

Objective: The Veterans Choice Program (VCP) of the Veterans Health Administration (VHA) allowed eligible veterans to use their benefits with participating providers outside the VHA. The authors aimed to identify characteristics of veterans with depression who used or did not use mental health care through the VCP. Methods: In this cross-sectional study, the authors analyzed secondary data from the national VHA Corporate Data Warehouse. VHA administrative data were linked with VCP claims to examine characteristics of VCP-eligible veterans with depression. Further, the study sample included 595,943 unique veterans who were enrolled in the VHA before 2013, were eligible for the VCP in 2016, were alive in 2018, and had an assessed Patient Health Questionnaire–9 (PHQ-9) score or depressive disorder diagnosis documented in the VHA between 2016 and 2018. Results: Veterans who used the VCP had lower medical comorbidity scores and lived in less socioeconomically disadvantaged counties, compared with veterans who received only VHA care. VCP veterans were also more likely to have a PHQ-9 score assessment and to have higher mean depression scores. Mean counts of annual mental health visits per 1,000 veterans were markedly higher for direct VHA care than for care provided via the VCP. As a percentage of the total counts of visits per 1,000 veterans across the VCP and VHA, residential programs and outpatient procedures were the services that were most frequently delivered through the VCP. Conclusions: Between 2016 and 2018, the VCP was used primarily to augment mental health care provided by the VHA, rather than to fill a gap in care.

Research Organization:
Los Alamos National Laboratory (LANL), Los Alamos, NM (United States)
Sponsoring Organization:
USDOE Laboratory Directed Research and Development (LDRD) Program; USDOE National Nuclear Security Administration (NNSA)
Grant/Contract Number:
89233218CNA000001
OSTI ID:
2315660
Report Number(s):
LA-UR-23-29071
Journal Information:
Psychiatric Services, Vol. 75, Issue 4; ISSN 1075-2730
Publisher:
American Psychiatric Association PublishingCopyright Statement
Country of Publication:
United States
Language:
English

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