A retrospective cohort study of comorbidity trajectories associated with traumatic brain injury in veterans of the Iraq and Afghanistan wars

Pugh, Mary Jo; Finley, Erin P.; Wang, Chen-Pin; Copeland, Laurel A.; Jaramillo, Carlos; Swan, Alicia A.; Elnitsky, Christine; Leykum, Luci K.; Mortensen, Eric M.; Eapen, Blessen; Noël, Polly Hitchcock; Pugh, Jacqueline A.

doi:10.1080/02699052.2016.1219055

Cited by 63 publications

(50 citation statements)

References 42 publications

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“…However, higher levels of care coordination may be warranted due to greater healthcare need (e.g., multiple comorbidities, advanced or more severe conditions), limited personal resources, and frequent cross-system use. 7,[21][22][23] In addition to PACT, VA Office of Community Care has developed a triage tool to differentiate Veterans with low, moderate, or high needs for coordination to facilitate coordination and navigation within and outside the VA. This tool also helps in documenting the intensity ("dosage") of coordination delivered.…”

Section: Identifying Veterans Who Benefit Most From Care Coordinationmentioning

confidence: 99%

Recommendations for the Evaluation of Cross-System Care Coordination from the VA State-of-the-art Working Group on VA/Non-VA Care

et al. 2019

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Development Service hosted a VA State of the Art conference (SOTA) focused on care coordination. The SOTA convened VA researchers, program directors, clinicians, and policy makers to identify knowledge gaps regarding care coordination within the VA and between VA and community systems of care. This article provides a summary and synthesis of relevant literature and provides recommendations generated from the SOTA about how to evaluate cross-system care coordination. Care coordination is typically evaluated using health outcomes including hospital readmissions and death; however, in cross-system evaluations of care coordination, measures such as access, cost, Veteran/patient and provider satisfaction (including with cross-system communication), comparable quality metrics, context (urban vs. rural), and patient complexity (medical and mental health conditions) need to be included to fully evaluate care coordination effectiveness. Future research should examine the role of multiple individuals coordinating VA and non-VA care, and how these coordinators work together to optimize coordination. KEY WORDS: Veterans; care coordination; health information interoperability; delivery of healthcare.

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Section: Identifying Veterans Who Benefit Most From Care Coordinationmentioning

confidence: 99%

Recommendations for the Evaluation of Cross-System Care Coordination from the VA State-of-the-art Working Group on VA/Non-VA Care

et al. 2019

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“…TBI was most common in the PCT trajectory for both men and women. Women in the mental health and PCT trajectories were more likely than men to be diagnosed with depression …”

Section: Resultsmentioning

confidence: 88%

“…Women in the mental health and PCT trajectories were more likely than men to be diagnosed with depression. 32 Interpersonal Violence Iverson and Pogoda found that 18.8% of their allfemale sample (n = 176) reported a history of TBI from IPV in a cross-sectional survey by mail. Women with IPVrelated TBI reported poorer mental and physical health than women with no head injury.…”

Section: Comorbidity Phenotypesmentioning

confidence: 99%

Gender Differences in Outcomes after Traumatic Brain Injury among Service Members and Veterans

Cogan

McCaughey

Scholten

2019

PM&R

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This scoping study describes the range of outcomes in traumatic brain injury (TBI) studies of military service members and veterans addressing gender differences. A secondary purpose is to identify differences in outcomes between male and female participants in such studies. We searched PubMed, CiNAHL, and PsycInfo databases for relevant articles. Two reviewers independently screened results. Of 822 unique titles and abstracts screened for eligibility, 55 full articles were reviewed, with 29 studies meeting full inclusion criteria. Twenty of the 29 included studies used retrospective designs and all but two used data collected from Veterans Affairs or Department of Defense health care settings. TBI was diagnosed by self‐report, screening, and evaluation procedures, and medical record documentation. Ten different outcome categories were identified among the included studies. In general, female service members and veterans have not been well represented in TBI outcomes research. Evidence suggests that female veterans with mild TBI (mTBI) report more neurobehavioral symptoms and use more outpatient services than male veterans. Studies also indicate that female veterans with TBI are more frequently diagnosed with depression. Additional research is essential to support precision treatment recommendations for female veterans with TBI, as women represent a growing proportion of the patients served by the Veterans Health Administration. Level of Evidence IV

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“…In terms of chronic pain, female veterans are more likely to report headache and depression following TBI, whereas male veterans are more likely to report low-back pain after the injury. 61 Although the inciting event of TBI may be a purely mechanical injury leading to structural damage, significant morbidity following the trauma stems from psychological or psychiatric sequelae. It has been found that female veterans have a higher incidence of posttraumatic stress disorders (PTSDs) independent of TBI.…”

Section: Tbi In Female Veteransmentioning

confidence: 99%

“…In contrast, the only significant risk factor for unemployment among female veterans included in this study was the presence of affective or cognitive symptoms. 2 Other potential barriers to successful integration back into civilian society specific to men include a significantly higher risk of developing a comorbid substance use disorder 27,61 and dementia following the injury. 71 This suggests that male and female veterans may need different, targeted resources to facilitate employment.…”

Section: Tbi In Male Veteransmentioning

confidence: 99%

Traumatic brain injury among female veterans: a review of sex differences in military neurosurgery

Kim

Quon

Sun

et al. 2018

Neurosurgical Focus

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The impact of traumatic brain injury (TBI) has been demonstrated in various studies with respect to prevalence, morbidity, and mortality data. Many of the patients burdened with long-term sequelae of TBI are veterans. Although fewer in number, female veterans with TBI have been suggested to suffer from unique physical, mental, and social challenges. However, there remains a significant knowledge gap in the sex differences in TBI. Increased female representation in the military heralds an increased risk of TBI for female soldiers, and medical professionals must be prepared to address the unique health challenges in the face of changing demographics among the veteran TBI population. In this review, the authors aimed to present the current understanding of sex differences in TBI in the veteran population and suggest directions for future investigations.

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A retrospective cohort study of comorbidity trajectories associated with traumatic brain injury in veterans of the Iraq and Afghanistan wars

Cited by 63 publications

References 42 publications

Recommendations for the Evaluation of Cross-System Care Coordination from the VA State-of-the-art Working Group on VA/Non-VA Care

Recommendations for the Evaluation of Cross-System Care Coordination from the VA State-of-the-art Working Group on VA/Non-VA Care

Gender Differences in Outcomes after Traumatic Brain Injury among Service Members and Veterans

Traumatic brain injury among female veterans: a review of sex differences in military neurosurgery

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