PMID- 20355260
OWN - NLM
STAT- MEDLINE
DCOM- 20100412
LR  - 20191210
IS  - 1537-1948 (Electronic)
IS  - 0025-7079 (Linking)
VI  - 48
IP  - 4
DP  - 2010 Apr
TI  - Predisposing characteristics, enabling resources and need as predictors of 
      utilization and clinical outcomes for veterans receiving mental health services.
PG  - 288-95
AB  - BACKGROUND: Though demand for mental health services (MHS) among US veterans is 
      increasing, MHS utilization per veteran is decreasing. With health and social 
      service needs competing for limited resources, it is important to understand the 
      association between patient factors, MHS utilization, and clinical outcomes. 
      OBJECTIVES: We use a framework based on Andersen's behavioral model of health 
      service utilization to examine predisposing characteristics, enabling resources, 
      and clinical need as predictors of MHS utilization and clinical outcomes. 
      METHODS: This was a prospective observational study of veterans receiving 
      inpatient or outpatient MHS through Veterans Administration programs. Clinician 
      ratings (Global Assessment of Functioning [GAF]) and self-report assessments 
      (Behavior and Symptom Identification Scale-24) were completed for 421 veterans at 
      enrollment and 3 months later. Linear and logistic regression analyses were 
      conducted to examine: (1) predisposing characteristics, enabling resources, and 
      need as predictors of MHS inpatient, residential, and outpatient utilization and 
      (2) the association between individual characteristics, utilization, and clinical 
      outcomes. RESULTS: Being older, female, having greater clinical need, lack of 
      enabling resources (employment, stable housing, and social support), and easy 
      access to treatment significantly predicted greater MHS utilization at 3-month 
      follow-up. Less clinical need and no inpatient psychiatric hospitalization 
      predicted better GAF and Behavior and Symptom Identification Scale-24 scores. 
      White race and residential treatment also predicted better GAF scores. Neither 
      enabling resources, nor number of outpatient mental health visits predicted 
      clinical outcomes. CONCLUSIONS: This application of Andersen's behavioral model 
      of health service utilization confirmed associations between some predisposing 
      characteristics, need, and enabling resources on MHS utilization but only 
      predisposing characteristics, need, and utilization were associated with clinical 
      outcomes.
FAU - Fasoli, DiJon R
AU  - Fasoli DR
AD  - Center for Health Quality, Outcomes, and Economic Research, Edith Nourse Rogers 
      Memorial Veterans Hospital, Bedford, MA, USA. dfasoli@bu.edu
FAU - Glickman, Mark E
AU  - Glickman ME
FAU - Eisen, Susan V
AU  - Eisen SV
LA  - eng
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - United States
TA  - Med Care
JT  - Medical care
JID - 0230027
SB  - IM
MH  - Adult
MH  - Boston
MH  - Female
MH  - Forecasting
MH  - Health Care Surveys
MH  - *Health Services Needs and Demand
MH  - Humans
MH  - Linear Models
MH  - Logistic Models
MH  - Male
MH  - Mental Health Services/*statistics & numerical data
MH  - Middle Aged
MH  - Observation
MH  - *Outcome Assessment, Health Care
MH  - Prospective Studies
MH  - Veterans/*psychology
EDAT- 2010/04/01 06:00
MHDA- 2010/04/13 06:00
CRDT- 2010/04/01 06:00
PHST- 2010/04/01 06:00 [entrez]
PHST- 2010/04/01 06:00 [pubmed]
PHST- 2010/04/13 06:00 [medline]
AID - 10.1097/mlr.0b013e3181cafbe3 [doi]
PST - ppublish
SO  - Med Care. 2010 Apr;48(4):288-95. doi: 10.1097/mlr.0b013e3181cafbe3.