|
BACKGROUND/RATIONALE:
A significant number of 1991 Gulf War veterans experienced debilitating symptoms that could not be linked to a specific disease. In 1995 Congress gave VA the authority to compensate certain veterans with undiagnosed illness through passage of PL 103-446. The purpose of this epidemiologic database study is to understand better the characteristics of the veterans who have been compensated for undiagnosed illness and to determine the effect of this compensation decision on the veteran's use of VA healthcare services. We propose a retrospective cohort study of subgroups of N=697,000 veterans who served in the Gulf War between August 2, 1990 and July 31, 1991. The approach is highly quantitative in that we shall use existing databases from VA and Department of Defense (DOD) and adopt multivariate statistical methods to compare demographic, military characteristics, and health care utilization of subgroups who 1) receive compensation for undiagnosed illness (n=3000), 2) receive compensation for other conditions, 3) were denied compensation for undiagnosed illness, and 4) responded to the National Health Survey of Gulf War Era Veterans.
OBJECTIVE(S):
Using epidemiologic methods, we shall address the primary research question: Do Gulf War veterans who have been granted compensation for undiagnosed illness have a unique profile of demographic, military, in-theater environmental exposures, and psychosocial morbidity that is distinct from that of all 697,000 veterans of the 1991 Gulf War. Secondly, we shall evaluate the effect of being approved for compensation for undiagnosed illness in terms of utilization of out-patient and in-patient health care services at VA facilities.
METHODS:
Information will be obtained by linking five electronic databases: (1) The VBA Compensation and Pension Master Record File, which is the source of data on compensation granted or denied, diagnostic codes, and psychosocial variables; (2) The Army Center for Health Promotion and Preventive Medicine, which will provide data on exposures; (3) the VHA Medical Outpatient Datasets; (4) The VHA Medical Inpatient Datasets; and (5) The National Health Survey of 30,000 Gulf War-Era Veterans. We shall evaluate data quality of specific variables from these databases; cluster analyses will be used to determine whether the veterans compensated for undiagnosed illnesses form clusters of patients based upon their characteristics. Characteristics include demographic, military, environmental exposures, and psychosocial variables. We shall assess changes in health care utilization from the 2 year period before and the 2 year period after the compensation decision. Multivariate analyses include multiple linear or logistic regression analysis, use of propensity score to reduce the number of independent variables, log-linear modeling, and discriminant analysis. There will be no new data collected on veterans.
FINDINGS/RESULTS:
No results at this time.
IMPACT:
Not yet available.
PUBLICATIONS:
None at this time.
DRA:
Chronic Diseases, Health Services and Systems, Military and Environmental Exposures
DRE:
none
Keywords:
Research method, Utilization patterns, Gulf War I
MeSH Terms:
none
|
