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Mental Health Conditions and Hospitalizations for Ambulatory Care Sensitive Conditions Among Veterans with Diabetes.

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  • Additional Information
    • Affiliation:
      Director, War Related Illness and Injury Study Center (WRIISC), Veterans Affairs (VA) New Jersey Healthcare System, East Orange
      Assistant Professor, Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown
      WRIISC, VA New Jersey Healthcare System
      Health Research Scientist, Veteran Affairs Greater Los Angeles Healthcare System, Sepulveda, CA
      Epidemiologist, WRIISC, VA New Jersey Healthcare System
      Professor, Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      BACKGROUND: Veterans with diabetes and mental health conditions have a higher risk for suboptimal care and complications related to their diseases than veterans with diabetes who do not have mental health conditions. We hypothesized that among veterans with diabetes, patients with mental health conditions are more likely to be hospitalized for ambulatory care sensitive conditions (ACSC) than those without mental health conditions. OBJECTIVE: To examine the association between depression, anxiety, and serious mental illness and hospitalizations for ACSC among veterans with diabetes after controlling for demographics and comorbidities. METHODS: We used a retrospective cohort design with merged Veterans Health Administration (VHA) and Medicare electronic health records from 2008 to 2010. Andersen's Behavioral Model of Health Services Use was used to select the variables associated with hospitalizations for ACSC (ie, predisposing, enabling and need characteristics, personal health practices, and external environment). We used chisquare tests and logistic regressions for our analyses. RESULTS: Among the dual VHA/Medicare-enrolled veterans with any hospitalization in 2010, 30% had hospitalizations for ACSC. Veterans with diabetes and co-occurring depression were at increased likelihood to be hospitalized for ACSC, after adjusting for all other covariates (adjusted odds ratio, 1.08; 95% confidence interval, 1.04-1.11). Similar findings were observed for anxiety. Veterans with serious mental illness were as likely as veterans without serious mental illness to be hospitalized for ACSC. CONCLUSION: Veterans with depression and anxiety were more likely to be hospitalized for any or acute ACSC than veterans without mental health conditions. Patients hospitalized for acute ACSC were more susceptible than patients hospitalized for chronic ACSC to have mental health conditions. As the VHA continues to evolve from care provider to community care payer (per the Veterans Affairs MISSION Act), our results highlight the ongoing importance of care coordination and communication between payers and providers.
    • Journal Subset:
      Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Health Services Administration; Peer Reviewed; USA
    • ISSN:
      1942-2962
    • Publication Date:
      20200516
    • Publication Date:
      20200518
    • Accession Number:
      143175605
  • Citations
    • ABNT:
      HELMER, D. A. et al. Mental Health Conditions and Hospitalizations for Ambulatory Care Sensitive Conditions Among Veterans with Diabetes. American Health & Drug Benefits, [s. l.], v. 13, n. 2, p. 61–71, 2020. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143175605. Acesso em: 27 set. 2020.
    • AMA:
      Helmer DA, Dwibedi N, Rowneki M, et al. Mental Health Conditions and Hospitalizations for Ambulatory Care Sensitive Conditions Among Veterans with Diabetes. American Health & Drug Benefits. 2020;13(2):61-71. Accessed September 27, 2020. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143175605
    • APA:
      Helmer, D. A., Dwibedi, N., Rowneki, M., Chin-Lin Tseng, Fried, D., Rose, D., Jani, N., & Sambamoorthi, U. (2020). Mental Health Conditions and Hospitalizations for Ambulatory Care Sensitive Conditions Among Veterans with Diabetes. American Health & Drug Benefits, 13(2), 61–71.
    • Chicago/Turabian: Author-Date:
      Helmer, Drew A., Nilanjana Dwibedi, Mazhgan Rowneki, Chin-Lin Tseng, Dennis Fried, Danielle Rose, Nisha Jani, and Usha Sambamoorthi. 2020. “Mental Health Conditions and Hospitalizations for Ambulatory Care Sensitive Conditions Among Veterans with Diabetes.” American Health & Drug Benefits 13 (2): 61–71. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143175605.
    • Harvard:
      Helmer, D. A. et al. (2020) ‘Mental Health Conditions and Hospitalizations for Ambulatory Care Sensitive Conditions Among Veterans with Diabetes’, American Health & Drug Benefits, 13(2), pp. 61–71. Available at: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143175605 (Accessed: 27 September 2020).
    • Harvard: Australian:
      Helmer, DA, Dwibedi, N, Rowneki, M, Chin-Lin Tseng, Fried, D, Rose, D, Jani, N & Sambamoorthi, U 2020, ‘Mental Health Conditions and Hospitalizations for Ambulatory Care Sensitive Conditions Among Veterans with Diabetes’, American Health & Drug Benefits, vol. 13, no. 2, pp. 61–71, viewed 27 September 2020, .
    • MLA:
      Helmer, Drew A., et al. “Mental Health Conditions and Hospitalizations for Ambulatory Care Sensitive Conditions Among Veterans with Diabetes.” American Health & Drug Benefits, vol. 13, no. 2, May 2020, pp. 61–71. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143175605.
    • Chicago/Turabian: Humanities:
      Helmer, Drew A., Nilanjana Dwibedi, Mazhgan Rowneki, Chin-Lin Tseng, Dennis Fried, Danielle Rose, Nisha Jani, and Usha Sambamoorthi. “Mental Health Conditions and Hospitalizations for Ambulatory Care Sensitive Conditions Among Veterans with Diabetes.” American Health & Drug Benefits 13, no. 2 (May 2020): 61–71. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143175605.
    • Vancouver/ICMJE:
      Helmer DA, Dwibedi N, Rowneki M, Chin-Lin Tseng, Fried D, Rose D, et al. Mental Health Conditions and Hospitalizations for Ambulatory Care Sensitive Conditions Among Veterans with Diabetes. American Health & Drug Benefits [Internet]. 2020 May [cited 2020 Sep 27];13(2):61–71. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143175605