Discrepancies in diagnostic records of military service members with self-reported PTSD: Healthcare use and longitudinal symptom outcomes
| Autor: | Xian Liu, Maria A Morgan, Daniel P. Evatt, Kevin O'Gallagher, Marija Spanovic Kelber, Bradley E. Belsher |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Active duty Binomial regression Military service Adjustment disorders behavioral disciplines and activities Diagnosis Differential Stress Disorders Post-Traumatic Adjustment Disorders 03 medical and health sciences 0302 clinical medicine Risk Factors Electronic health record mental disorders Health care medicine Electronic Health Records Humans Longitudinal Studies 030212 general & internal medicine Medical diagnosis Psychiatry Referral and Consultation business.industry Service member Prognosis medicine.disease United States 030227 psychiatry Psychiatry and Mental health Cross-Sectional Studies Military Personnel Treatment Outcome Utilization Review Female Self Report business |
| Zdroj: | General Hospital Psychiatry. 58:33-38 |
| ISSN: | 0163-8343 |
| DOI: | 10.1016/j.genhosppsych.2019.02.006 |
| Popis: | Objective The study compared healthcare utilization and posttraumatic stress disorder (PTSD) symptom trajectories of active duty service members (ADSM) with self-reported PTSD based on whether they had a PTSD diagnosis in the electronic health record (EHR). Methods ADSM meeting study criteria for self-reported PTSD (N = 470) were grouped according to EHR-PTSD diagnostic status. Participants completed PTSD symptom assessments over a 12 month period. We used log binomial regression and linear mixed model to examine predictors of receiving an EHR-PTSD diagnosis and to analyze healthcare utilization and symptom trajectories based on diagnostic status. Results Thirty percent of ADSM with study-identified PTSD had an EHR-PTSD diagnosis. Combat exposure and PTSD severity predicted EHR-PTSD diagnosis. ADSM without the diagnosis were more likely to have an adjustment disorder diagnosis. Participants with an EHR-PTSD diagnosis utilized more healthcare and reported worse PTSD symptoms over 12 months. Conclusions Findings suggest providers are more likely to record PTSD diagnoses for more severe, complex cases. While less severe cases may be less likely to receive a PTSD diagnosis, they may still access and benefit from care. Findings have implications for use of EHRs to describe health patterns and inform practices and policy in the Military Health System. |
| Databáze: | OpenAIRE |
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