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Longitudinal Patterns of Health System Retention Among Veterans with Schizophrenia or Bipolar Disorder

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Abstract

Inconsistent service use for schizophrenia and bipolar disorder is associated with poorer outcomes of care. We analyzed VHA National Psychosis Registry data for 164,150 veterans with these disorders to identify characteristics associated with 5-year patterns of survival and with retention in VHA care. Most cohort members (63%) survived the period with no break in VHA healthcare lasting over 12 months. Inconsistent utilization was associated with younger age, no service-connected disability, and less physical comorbidity, regardless of diagnosis. The influence of gender and ethnicity on attrition varied by diagnosis and gap-duration. Variation in attrition by gender and ethnicity warrants additional attention.

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Acknowledgments

The research reported in this manuscript was supported by the Department of Veterans Affairs Health Services Research and Development Service grant TXI01-014, and partially supported by the VA Serious Mental Illness Treatment Research and Evaluation Center, the VA HSR&D Center for Mental Healthcare and Outcomes Research, and the VA Mental Health QUERI.

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Correspondence to Ellen P. Fischer.

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Fischer, E.P., McCarthy, J.F., Ignacio, R.V. et al. Longitudinal Patterns of Health System Retention Among Veterans with Schizophrenia or Bipolar Disorder. Community Ment Health J 44, 321–330 (2008). https://doi.org/10.1007/s10597-008-9133-z

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  • DOI: https://doi.org/10.1007/s10597-008-9133-z

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