Lewis E. Kazis|Donald R. Miller|Jack A. Clark|Katherine M. Skinner|Austin Lee|William H. Rogers|Avron Spiro|Susan N. Payne|Graeme Fincke|Alfredo J. Selim|Mark Linzer
Health-Related Quality of Life in Patients Served by the Department of Veterans Affairs
Harvard University Press
h3backgroundh3 department veterans affairs health care system va largest integrated single payer system united states date systematic measurement health status va veterans health study developed methods assess patientbased health status ambulatory populations h3objectivesh3 describe health status veterans examine relationships healthrelated quality life age comorbidity socioeconomic serviceconnected disability status h3methodsh3 participants veterans health study 2year longitudinal study recruited representative sample patients receiving ambulatory care 4 va facilities new england region veterans health study patients received questionnaires health status including medical outcomes study short form 36item health survey health examination clinical assessments medical history taking sixteen hundred sixtyseven patients conducted baseline assessments described h3resultsh3 va outpatients poor health status scores across measures medical outcomes study short form 36item health survey compared scores nonva populations least 50 1 sd worse striking differences also found sample stratified age group 2049 years 5064 years 6590 years 7 8 scales role limitations due physical problems bodily pain general health perceptions vitality social functioning role limitations due emotional problems mental health scores considerably lower among younger patients eighth scale physical function scores young veterans aged 2049 years almost comparable levels old veterans gt65 years mental health scores young veterans substantially worse age groups ipilt001 scores screening measures depression significantly higher youngest age group 51 compared oldest age groups 33 16 ipilt001 h3conclusionsh3 va outpatients substantially worse health status nonva populations mental health differences young old veterans use va health care system sharply contrasting young veterans sicker suggesting substantially higher resource needs mental health differences may explain much worse healthrelated quality life young veterans health care systems continue undergo radical transformation department veterans affairs focus provision mental health services younger veteran