Health services research · 2025
Veteran Mental Health Emergency Care Utilization Following SARS-CoV-2 Infection.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Chen Jason I, Niederhausen Meike, Bui David P, Govier Diana J, Rowneki Mazhgan, Hickok Alex, Shahoumian Troy A, Shepherd-Banigan Megan, Korpak Anna, Hawkins Eric, Teo Alan R, Naylor Jennifer, Osborne Thomas F, Smith Valerie A, Bowling C Barrett, Boyko Edward J, Ioannou George N, Maciejewski Matthew L, O'Hare Ann M, Viglianti Elizabeth M, Iwashyna Theodore J, Bohnert Amy S B, Hynes Denise M, VA HSR&D COVID‐19 Observational Research Collaboratory (CORC)
Аннотация
OBJECTIVE: To evaluate whether Veterans infected with SARS-CoV-2 have an elevated risk for needing mental health emergency care (MHEC) relative to uninfected comparators, as measured by emergency department or urgent care clinic utilization for a mental health diagnosis.
DATA SOURCES/EXTRACTION: Data from Veterans Health Administration (VHA), VHA-paid, and Centers for Medicare & Medicaid-paid services were used to identify incident MHEC use within 1 year of infection for Veterans with a SARS-CoV-2 infection and matched comparators.
STUDY DESIGN: This was a national, retrospective cohort study that leveraged a target trial emulation framework to examine long-term outcomes of SARS-CoV-2 infection among Veterans enrolled in VHA care. Uninfected comparators were matched based on month of infection, demographic, clinical, and health care utilization characteristics. We calculated cumulative incidence rates per 10,000 persons and utilized Cox regression models to estimate hazard ratios (HR) for MHEC up to one year post-infection.
PRINCIPAL FINDINGS: The cohort included 207,968 Veterans with SARS-CoV-2 and 1,036,944 comparators. The 365-day incidence of MHEC use was greater among SARS-CoV-2 patients than comparators (HR = 1.48; 95% CI: [1.44, 1.52]). Patients with SARS-CoV-2 had a higher hazard for MHEC use than comparators in all timeframes analyzed.
CONCLUSIONS: SARS-CoV-2 infection was associated with increased MHEC use. Active care coordination with existing mental health treatment providers may help mitigate post-infection mental health distress. Future research should explore specific contextual factors contributing to MHEC, such as gaps in continuity of care.
DATA SOURCES/EXTRACTION: Data from Veterans Health Administration (VHA), VHA-paid, and Centers for Medicare & Medicaid-paid services were used to identify incident MHEC use within 1 year of infection for Veterans with a SARS-CoV-2 infection and matched comparators.
STUDY DESIGN: This was a national, retrospective cohort study that leveraged a target trial emulation framework to examine long-term outcomes of SARS-CoV-2 infection among Veterans enrolled in VHA care. Uninfected comparators were matched based on month of infection, demographic, clinical, and health care utilization characteristics. We calculated cumulative incidence rates per 10,000 persons and utilized Cox regression models to estimate hazard ratios (HR) for MHEC up to one year post-infection.
PRINCIPAL FINDINGS: The cohort included 207,968 Veterans with SARS-CoV-2 and 1,036,944 comparators. The 365-day incidence of MHEC use was greater among SARS-CoV-2 patients than comparators (HR = 1.48; 95% CI: [1.44, 1.52]). Patients with SARS-CoV-2 had a higher hazard for MHEC use than comparators in all timeframes analyzed.
CONCLUSIONS: SARS-CoV-2 infection was associated with increased MHEC use. Active care coordination with existing mental health treatment providers may help mitigate post-infection mental health distress. Future research should explore specific contextual factors contributing to MHEC, such as gaps in continuity of care.