Quality of Care for PTSD and Depression in the Military Health System
RAND NATIONAL DEFENSE RESEARCH INST SANTA MONICA CA SANTA MONICA
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The U.S. Department of Defense DoD strives to maintain a physically and psychologically healthy, mission-ready force, and the care provided by the Military Health System MHS is critical to meeting this goal. Attention has been directed to ensuring the quality and availability of programs and services for posttraumatic stress disorder PTSD and depression. This report is a comprehensive assessment of the quality of care delivered by the MHS in 20132014 for over 38,000 active-component service members with PTSD or depression. The assessment includes performance on 30 quality measures to evaluate the receipt of recommended assessments and treatments. These measures draw on multiple data sources including administrative encounter data, medical record review data, and patient self-reported outcome monitoring data. The assessment identified strengths and areas for improvement for the MHS. In particular, the MHS excels at screening for suicide risk and substance use, but rates of appropriate follow-up for service members with suicide risk are lower. Most service members received at least some psychotherapy, but less than half of psychotherapy delivered was evidence-based. In analyses focused on Army soldiers, outcome monitoring increased notably over time, yet preliminary analyses suggest that more work is needed to ensure that services are effective in reducing symptoms. When comparing performance between 20122013 and 20132014, most measures demonstrated slight improvement, but targeted efforts will be needed to support further improvements. RAND provides recommendations for strategies to improve the quality of care delivered for these conditions.
- Medicine and Medical Research
- Military Forces and Organizations