Where vets served affects frequency of ER visits but not hospital stays

Five years post-conflict, individuals who served in the 1990-1991 Persian Gulf War were 25 percent more likely to visit an emergency department than veterans of the same era who were not deployed, but were no more likely to have a hospital stay or an outpatient visit, according to a study appearing in the December 2007 issue of the American Journal of Public Health.

“In light of Gulf War illnesses, we were surprised that we did not find an impact of service in the Gulf on hospital stays and outpatient visits,” said Bradley N. Doebbeling, M.D., M.Sc., senior author of the study. He is director of Health Services Research and research scientist at Regenstrief Institute, Inc.; director of the Indiana University Center for Health Services and Outcomes Research; professor of health services research and medicine at the Indiana University School of Medicine; director of the VA Health Services Research and Development Center of Excellence on Implementing Evidence-Based Practice, Richard L. Roudebush VA Medical Center.

“Our study calls into question whether access to care for returning veterans is adequate or needs to be enhanced. Right now, it's up to the U.S. Congress to determine,” said Dr. Doebbeling.

This large population based study examined fifth-year post-conflict visits for both physical and mental illnesses of military personnel from Iowa on active duty August 1990 to July 1991. In both the deployed and nondeployed veterans, National Guard and Reserve personnel were more likely to have been hospitalized than regular military personnel.

Veterans who served in the Gulf were more often younger, male, enlisted, less educated and more likely to serve in the Army or Marines than non-deployed veterans.

The study noted that many Persian Gulf War personnel reported a variety of symptoms, such as body pain, difficulty thinking, depression, and other complaints. Theoretically, given their symptoms, these veterans should have higher health-care use than nondeployed Persian Gulf War–era veterans.

The study authors suggest two explanations for their findings. The higher probability of emergency department visits by Persian Gulf War veterans could have resulted from limited access to outpatient services. Alternatively, veterans could have had higher rates of accidents and injuries.