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Greg Greenberg, Phd, Northeast Program Evaluation Center, VAMC West Haven, Ct. as well as Yale University Department of Psychiatry, New Haven, CT., VA Northeast Program Evaluation Center /182, 950 Campbell Ave, New haven, CT 06511, 203-789-0487, greenberg@biomed.med.yale.edu and Robert A. Rosenheck, MD, Northeast Administration Evaluation Center (NEPEC), Veterans Administration Medical Center, 950 Campbell Avenue, West Haven, CT 06516.
Background: Regional variation in health service use is common and although less well documented it has also been found to occur with respect to mental health services. It is unknown the degree to which regional variation in mental health service use is affected by system reform, such as increased emphasis on outpatient care and quality monitoring. Methods: We used information from the Department of Veterans Affairs’ (VA) National Mental Health Performance Monitoring System to create risk adjusted service use measures for the VA’s 22 regional networks for 1996 and 2001. We then examined the change between these two years in the coefficient of variation for each measure. Results: As indicated by the coefficient of variation for 14 of 24 measures there was sizable variation (>.20) in service use patterns across the VA’s 22 regional networks. For half of these 14 measures there was a substantial increase (20% or greater) between 1996 and 2001 in the coefficient of variation, a moderate increase for 4 measures (10% to 16%), and a lack of change or decrease for 3 measures (-84% to 3%). Of the 10 measures for which the coefficient of variations was below .20 in 1991 half had a large increase in their coefficient of variation, 4 had a small decline (-3 to -9%), and one had a large decline (-284%). Conclusions: Geographic variations in the pattern of mental health service use generally increased during a period of VA reform. It is possible that system changes contributed to this trend because of differences between regions in receptivity to change.
Learning Objectives: Learning Objectives - - At the conclusion of this session, the learner will be able to
Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employer