Healthcare utilization and costs of Veterans screened and assessed for traumatic brain injury

Kevin T. Stroupe, Bridget M. Smith, Timothy P. Hogan, Justin R. St. Andre, Theresa Pape, Monica L. Steiner, Eric Proescher, Zhiping Huo, Charlesnika T. Evans

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Approximately 15% of casualties in the Afghanistan (Operation Enduring Freedom [OEF]) and Iraq (Operation Iraqi Freedom [OIF]) conflicts received mild traumatic brain injury (TBI). To identify Veterans who may benefit from treatment, the Department of Veterans Affairs (VA) implemented a national clinical reminder in 2007 to screen for TBI. Veterans who screen positive are referred for a comprehensive TBI evaluation. We conducted a national retrospective study of OIF/OEF Veterans receiving care at VA facilities between 2007 and 2008. We examined the association of the TBI screen with healthcare costs over a 12 mo period following the initial evaluation. Of the Veterans, 164,438 met inclusion criteria: 31,627 screened positive, 118,545 screened negative, and 14,266 received no TBI screening. Total healthcare costs of Veterans who screened positive, screened negative, or had no TBI screening were $9,610, $5,184, and $3,399, respectively (p < 0.001). Understanding these healthcare utilization and cost patterns will assist policymakers to address the ongoing and future healthcare needs of these returning Veterans.

Original languageEnglish (US)
Pages (from-to)1047-1068
Number of pages22
JournalJournal of Rehabilitation Research and Development
Issue number8
StatePublished - 2013
Externally publishedYes


  • Cost analysis
  • Department of Veterans affairs
  • Evaluation
  • Head injury
  • Healthcare costs
  • Healthcare utilization
  • Operation Iraqi freedom
  • Operation enduring freedom
  • Traumatic brain injury
  • Veterans

ASJC Scopus subject areas

  • Rehabilitation


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