Quality of Care for PTSD and Depression in the Military Health System

Abstract

The U.S. Department of Defense (DoD) strives to maintain a physically and psychologically healthy, mission-ready force, and the care provided by the Military Health System (MHS) is critical to meeting this goal. Attention has been directed to ensuring the quality and availability of programs and services for posttraumatic stress disorder (PTSD) and depression. This report is a comprehensive assessment of the quality of care delivered by the MHS in 20132014 for over 38,000 active-component service members with PTSD or depression. The assessment includes performance on 30 quality measures to evaluate the receipt of recommended assessments and treatments. These measures draw on multiple data sources including administrative encounter data, medical record review data, and patient self-reported outcome monitoring data. The assessment identified strengths and areas for improvement for the MHS. In particular, the MHS excels at screening for suicide risk and substance use, but rates of appropriate follow-up for service members with suicide risk are lower. Most service members received at least some psychotherapy, but less than half of psychotherapy delivered was evidence-based. In analyses focused on Army soldiers, outcome monitoring increased notably over time, yet preliminary analyses suggest that more work is needed to ensure that services are effective in reducing symptoms. When comparing performance between 20122013 and 20132014, most measures demonstrated slight improvement, but targeted efforts will be needed to support further improvements. RAND provides recommendations for strategies to improve the quality of care delivered for these conditions.

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Document Details

Document Type
Technical Report
Publication Date
Jun 13, 2018
Accession Number
AD1053671

Entities

People

  • Carol P. Roth
  • Elizabeth M. Sloss
  • Harold A. Pincus
  • Kimberly A Hepner
  • Martha J. Timmer
  • Praise O. Iyiewuare
  • Susan M. Paddock

Organizations

  • RAND Corporation

Tags

DTIC Thesaurus Topics

  • Afghanistan Conflict
  • Antidepressants
  • Anxiety Disorders
  • Brain Injuries
  • Data Analysis
  • Depression
  • Drug Abuse
  • Geographic Regions
  • Health Services
  • Medical Personnel
  • Military Medicine
  • Pharmacies
  • Psychiatry
  • Therapy
  • Traumatic Stress Disorder

Fields of Study

  • Medicine
  • Psychology

Readers

  • Defense Acquisition Program Management
  • Medical or Health Care Field.
  • Mental Health of Military Veterans with Posttraumatic Stress Disorder (PTSD): Risk Factors, Prevalence, Symptoms, and Treatment.