|
BACKGROUND/RATIONALE:
Care of our new OEF/OIF veterans is a priority for VA. The transition process from DOD to VA care has been little studied, but is an urgent concern for critically wounded OEF/OIF personnel. Already VA is caring for sharply increasing numbers of OEF/OIF veterans, increasing by 30,000 patients each year from FY04 (32,000) to FY06 (96,000). Data flow from DOD to VA electronic medical records has not been established, thus, developing working research relationships between VA and DOD entities is essential to analyzing transition between the systems. Our project will establish the feasibility of protocols to transfer PHI from a DOD medical treatment facility to VA, to permit study of critically wounded OEF/OIF veterans. Our findings will help VA understand and plan for the care of the OEF/OIF veterans, and lay groundwork for in-depth studies of coordination of care between DOD and VA for these complex patients.
OBJECTIVE(S):
The primary objectives are to establish the feasibility of DOD-to-VA PHI transfer on a local level, and to assess rates of transition to VA from BAMC for the cohort of BAMC patients seen during FY02-FY07. We will characterize types and timing of care subsequently received in the VA, and look at treatment retention in VA for at-risk subgroups, focusing on mental health care.
METHODS:
Working with collaborators at Brooke Army Medical Center, we will obtain IRB approvals from both DOD and VA, transfer patient identifiers from BAMC to our VA facility via encrypted media, and match identifiers to VA administrative databases. Our cohort study will follow approximately 1,300 OEF/OIF patients cared for at BAMC during FY02-FY07 into the VA through FY09. Cohort is 87% male, aged 18-67 (mean 37.8 years). BAMC case management tracking database will provide identifiers. Follow-up in VA will be via administrative databases. Quantitative methods will include covariate-adjusted Cox proportional hazard models for time to transition to VA. Results will be disseminated to BAMC collaborators, local VA administrators, and VA researchers, clinicians, and administrators. The information will help inform planning for seriously wounded OEF/OIF veterans entering the VA system now and in the near future.
FINDINGS/RESULTS:
No findings yet.
IMPACT:
Our study will determine the feasibility of PHI transmission from a DOD medical treatment facility to VA, and will estimate rates of transition to the VA healthcare system of critically injured OEF/OIF military personnel treated at the Department of Defense (DOD) Brooke Army Medical Center (BAMC). We will establish protocols for the exchange of medical data with BAMC collaborators. Our REAP is uniquely co-located with BAMC in San Antonio, enabling the development of a research agenda with the sole military medical treatment facility charged with care of military burn patients and one of a handful caring for traumatically injured non-burn patients from combat theaters.
PUBLICATIONS:
None at this time.
DRA:
Mental Illness, Special (Underserved, High Risk) Populations
DRE:
Quality of Care, Prevention
Keywords:
Access, Deployment Related
MeSH Terms:
none
|
