Employment After Vocational Rehabilitation Predicts Decreased Health Care Utilization in Veterans With Mental Health Diagnoses

Autor:	Tony Van, Sandra G. Resnick, Kristen M. Abraham, Kara Zivin, Ming-Un Myron Chang
Rok vydání:	2021
Předmět:	medicine.medical_specialty media_common.quotation_subject Aftercare Logistic regression Odds 03 medical and health sciences 0302 clinical medicine Health care Humans Medicine Medical diagnosis health care economics and organizations Veterans media_common business.industry Mental Disorders Public Health Environmental and Occupational Health Rehabilitation Vocational General Medicine Emergency department Patient Acceptance of Health Care Mental health Patient Discharge United States 030227 psychiatry United States Department of Veterans Affairs Mental Health Unemployment Family medicine Vocational rehabilitation business 030217 neurology & neurosurgery
Zdroj:	Military Medicine. 186:850-857
ISSN:	1930-613X 0026-4075
DOI:	10.1093/milmed/usab113
Popis:	Introduction Although the benefits of employment for veterans with mental health conditions are well-known, the effect of veterans’ employment on a health system has not been evaluated. The purpose of this study was to evaluate the effect of veterans’ employment (versus unemployment) on subsequent health care utilization in the Veterans Health Administration (VHA). Materials and Methods This study used a sample of 29,022 veterans with mental health and substance use disorders who were discharged from VHA’s employment services programs between fiscal years 2006 and 2010. Veterans’ employment status (employed/unemployed) upon discharge from VHA employment programs was ascertained from program discharge forms and linked with VHA administrative health care utilization data for the subsequent 1- and 5-year periods. Results Multivariable ordinary least-squares and logistic regression models adjusted for site clustering and covariates indicated that employment (versus unemployment) predicted less health care utilization 1 year and 5 years post-discharge from employment services, including fewer outpatient mental health visits, homelessness services visits, employment services visits, primary care visits, and lower odds of mental health hospitalizations, mental health or vocational rehabilitation residential stays, and medical hospitalizations. Employment did not predict emergency department visits. Conclusions VHA’s investment in employment services for veterans with mental health and substance use disorders could reduce health care utilization system wide.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::21025faa7f9765853900444a0195ac60 https://doi.org/10.1093/milmed/usab113 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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