Evaluating coordination and quality of care among veterans receiving posttraumatic stress disorder care in the community.

Abstract

Despite an increase in the number of veterans receiving posttraumatic stress disorder (PTSD) care in the community, little work has examined the coordination and quality of care, particularly as it relates to U.S. Department of Veterans Affairs (VA) standards. To this end, the current project sought to document community care characteristics among veterans receiving outpatient psychotherapy services for PTSD. Specifically, the coordination of care and congruency with VA standards were examined. Data, which were collected over a 2-year period from a VA hospital in the southeastern United States, included 123 PTSD community care consults across 103 unique veterans (M_age = 47.80 years, SD = 12.03; 72.4% Male; 50.4% Black). The majority of consults were new referrals for care (62.6%) due to the clinical service not being available or the average drive time to the nearest VA facility exceeding 30 min (77.2%). Regarding the coordination of care, records were not available for 27.6% of consults. Among veterans with treatment records, most were seen for an intake and psychotherapy (38.2%), followed by intake only and psychotherapy only. Formal diagnostic assessments were not documented in any intake records, with 21.2% of psychotherapy records documenting the use of a first-line treatment for PTSD. Notably, most intake records (56.1%) failed to document any assessment of suicide risk, and no psychotherapy records indicated the loss of a PTSD diagnosis. The findings highlight gaps in the coordination and quality of care, particularly as it relates to VA standards, for veterans receiving PTSD care in the community.