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    Health Care Utilization and Costs of Veterans Evaluated for Traumatic Brain Injury through Telehealth

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    Authors
    Stroupe, Kevin T.
    Martinez, Rachael
    Hogan, Timothy P.
    Evans, Charlesnika T.
    Scholten, Joel
    Bidelspach, Douglas
    Osteen, Chad
    Taylor, Brent C.
    Smith, Bridget M.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences, Division of Health Informatics and Implementation Science
    Document Type
    Journal Article
    Publication Date
    2019-03-15
    Keywords
    cost analysis
    head injury
    health care utilization
    operation enduring freedom
    operation Iraqi freedom
    traumatic brain injury
    veterans
    telemedicine
    telehealth
    e-health
    Epidemiology
    Health Services Administration
    Health Services Research
    Military and Veterans Studies
    Nervous System Diseases
    Telemedicine
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    Link to Full Text
    https://doi.org/10.1089/tmj.2018.0182
    Abstract
    BACKGROUND: Mild traumatic brain injury (TBI) is prevalent among Afghanistan (Operation Enduring Freedom [OEF]) and Iraq (Operation Iraqi Freedom [OIF]) Veterans. With clinical video telehealth (CVT), Veterans screening positive for potential deployment-related TBI can receive comprehensive TBI evaluations by providers at specialized centers through interactive video communication. INTRODUCTION: We examined health care utilization and costs for Veterans during the 12 months before and after being evaluated through CVT versus in-person. MATERIALS AND METHODS: We examined OEF/OIF Veterans receiving comprehensive evaluations at specialized Veterans Affairs facilities from October 2012 to September 2014. Veterans evaluated through CVT and in-person at the same facilities were included. We used a difference-in-difference analysis with propensity score weighted regression models to examine health care utilization and costs between TBI evaluation groups. RESULTS: There were 554 Veterans with comprehensive evaluations through CVT (380 with and 174 without confirmed TBI) and 7,159 with in-person evaluations (4,899 with and 2,260 without confirmed TBI). Veterans in the in-person group with confirmed TBI had similar increases in outpatient, inpatient, and total health care costs as Veterans who had TBI confirmed through CVT. However, Veterans with a confirmed TBI evaluated in-person had greater increases in rehabilitation and other specialty costs. DISCUSSION: When visits are in-person, Veterans may have opportunities to discuss more issues and concerns, whether TBI-related or not. Thus, providers might make more referrals to rehabilitation and specialty care after in-person visits. CONCLUSION: Veterans receiving in-person evaluations who were diagnosed with TBI had similar increases in health care costs as Veterans with TBI confirmed through evaluations through CVT.
    Source

    Telemed J E Health. 2019 Mar 15. doi: 10.1089/tmj.2018.0182. [Epub ahead of print] Link to article on publisher's site

    DOI
    10.1089/tmj.2018.0182
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46814
    PubMed ID
    30874499
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1089/tmj.2018.0182
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    Population and Quantitative Health Sciences Publications

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