Managing TIA & Stroke in the VA and DoD Systems

The burden and management of TIA and stroke in the Veterans Administration and Department of Defense. 07/18/09. Transient ischemic attack (TIA) and stroke are commonly occurring cerebrovascular events that require prompt and appropriate treatment to reduce the risk of secondary stroke. The US Department of Veterans Affairs (VA) and the Department of Defense constitute 2 large medical systems treating military personnel, both active and retired, as well as many of their dependents. In the area of stroke and TIA management, the VA in particular has instituted far-reaching measures, including those to ensure adherence to clinical treatment guidelines shown to produce optimal outcomes in stroke. The result of these measures has been that VA patients experience lower morbidity and mortality risk, as well as lower rates of stroke-related rehospitalization, than comparable patients treated through Medicare and Medicaid and in university hospitals. These successes in part may be an advantage derived from a relatively closed system with sufficient administrative discipline to maintain clinical guidelines treatment standards. It may also be the case that continuity of care in these systems produces better outcomes than more fragmentary treatment that may be experienced in the civilian realm. In addition, the VA system avoids incentivizing physicians for performing medical services, and instead incentivizes quality of care, which may provide a further advantage for patients treated within that system. American Journal of Managed Care via PubMed

Largest Study on Suicide in the Military Being Carried Out

Largest Ever Study Of Suicide In The Military 07/18/09. Four of the nation's leading experts in suicide research, including Dr. John Mann of Columbia University Medical Center, will carry out the largest study of suicide and mental health among military personnel ever undertaken, with $50 million in funding from the U.S. Army. The announcement came today from the National Institute of Mental Health (NIMH), which signed a memorandum of agreement with the Army in October 2008 authorizing the NIMH to undertake the investigation with Army funding. Study investigators aim to move quickly to identify risk and protective factors for suicide among soldiers and provide a science base for effective and practical interventions to reduce suicide rates and address associated mental health problems. Columbia University Medical Center via Medical News Today

Veterans With Mental Health Issues Increasing Dramatically

Mental Health Issues Among Veterans Increase Dramatically 07/18/09. A new study finds more veterans being diagnosed with mental health issues. The study was posted Thursday on the web site of The American Journal of Public Health. The New York Times reports: "A new study has found that more than one-third of Iraq and Afghanistan war veterans who enrolled in the veterans health system after 2001 received a diagnosis of a mental health problem, most often post-traumatic stress disorder or depression. The study by researchers at the San Francisco Department of Veterans Affairs Medical Center and the University of California, San Francisco, also found that the number of veterans found to have mental health problems rose steadily the longer they were out of the service. The study, released Thursday, was based on the department health records of 289,328 veterans involved in the two wars who used the veterans health system for the first time from April 1, 2002, to April 1, 2008." Kaiser Health News

Lack of Privacy for Female Veterans

Women Vets Don't Always Get Privacy At VA Clinics 07/15/09. Veterans Affairs hospitals and outpatient clinics under review are not always complying fully with federal privacy requirements, often exposing women when they bathe or receive exams, according to government auditors, The Associated Press reports. AP via Kaiser Health News

Moderate Alcohol Consumption in Veterans With PTSD Lowers Dementia Risk

PTSD associated with higher Alzheimer's/dementia risk; moderate alcohol consumption may lower it 07/13/09. Though discoveries about Alzheimer's risk factors are often in the news, adults do not know about the relationship between Alzheimer's risk and heart health, nor that physical activity can be protective, according to new research reported at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease. Two additional studies reported at ICAD 2009 show higher Alzheimer's risk in veterans with post-traumatic stress disorder, and lower Alzheimer's risk among adults who consume moderate amounts of alcohol. Alzheimer's Association via Eurekalert!