VA Health Care Utilization

Here is the VA health care utilization data of  Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn Veterans through February 28, 2015.

The VA cautions that the data only applies to OEF/OIF/OND veterans who have accessed VA health care and do not represent all OEF/OIF/OND veterans who have become eligible for VA health care since FY 2002 (beginning October 1, 2001) or the approximately 2.7 million troops (as of March 31, 2015) who have served or are serving in the two theaters of operation since the beginning of the conflicts in Iraq and Afghanistan:

VA health care utilization1,939,959 OEF/OIF/OND veterans have become eligible for VA health care since Fiscal Year 2002.

1,185,160 Approximately 61 percent are former Active Duty personnel

754,799 Approximately 39 percent are Reserve and National Guard personnel

Among all 1,939,959 separated OEF/OIF/OND veterans:

1,189,709 have obtained VA health care since FY 2002 (cumulative total)

735,945 Approximately 62 percent of former Active Duty personnel have obtained VA health care

453,764 Approximately 60 percent of Reserve/National Guard personnel have obtained VA health care

Among the 1,189,709 OEF/OIF/OND veterans who have received health care since FY 2002,

1,096,060 Approximately 92 percent have been seen only as outpatients by the VA

93,649 Approximately 8 percent have been hospitalized at least once in a VA health care facility

Comparison of VA health care utilization

Of the cumulative total of 1,189,709 OEF/OIF/OND Veterans who utilized VA health care from FY 2002 through the end of the second quarter in FY 2015, 723,143 veterans accessed care during the past 12 months (April 1, 2014-March 31, 2015). This represents about 10 percent of the approximately 6.6 million individuals who received VA health care during fiscal year 2014 (October 1, 2013 – September 30, 2014).

Demographic Characteristics of OEF/OIF/OND Veterans Utilizing VA Health Care*

VA health care utilization

*Hospitalization and outpatient visits recorded as of March 31, 2015.
**Beginning with the 4th Qtr FY 2012 report, the percentage of Coast Guard Veterans utilizing VA health care was added to the summary because the estimate reached a reportable level.

Veterans Integrated Service Network (VISN) Providing Treatment
OEF/OIF/OND Veterans Treated at a VA Facility*

Linthicum, Md.
Treatment Site Number Percent**
VISN 16: South Central VA Health Care Network
Ridgeland, Miss.
118,386 10.0
VISN 22: VA Desert Pacific Healthcare Network
Long Beach, Calif.
109,916 9.2
VISN 17: VA Heart of Texas Health Care Network
Arlington, Texas
105,017 8.8
VISN 7: VA Southeast Network
Duluth, Ga.
104,990 8.8
VISN 8: VA Sunshine Healthcare Network
St. Petersburg, Fla.
99,809 8.4
VISN 6: VA Mid-Atlantic Health Care Network
Durham, N.C.
98,528 8.3
VISN 18: VA Southwest Health Care Network
Gilbert, Ariz.
73,305 6.2
VISN 20: VA Northwest Health Network
Vancouver, Wash.
72,780 6.1
VISN 9: VA MidSouth Healthcare Network
Nashville, Tenn.
72,290 6.1
VISN 23: VA Midwest Health Care Network***
Minneapolis, Minn.
68,020 5.7
VISN 19: VA Rocky Mountain Network
Denver, Colo.
65,713 5.5
VISN 21: VA Sierra Pacific Network
Vallejo, Calif.
64,603 5.4
VISN 4: VA Stars & Stripes Healthcare System
Pittsburgh, Pa.
59,383 5.0
VISN 12: VA Great Lakes Health Care System
Westchester, Ill.
58,471 4.9
VISN 15: VA Heartland Network
Kansas City, Mo.
55,596 4.7
VISN 11: Veterans in Partnership Healthcare Network
Ann Arbor, Mich.
55,381 4.7
VISN 1: VA New England Healthcare System
Bedford, Mass.
51,623 4.3
VISN 5: VA Capitol Health Care System50,841 4.3
VISN 3: VA New York/New Jersey Healthcare System
Bronx, N.Y.
42,468 3.6
VISN 10: VA Healthcare System of Ohio
Cincinnati, Ohio
41,329 3.5
VISN 2: VA Healthcare Network Upstate New York
Albany, N.Y.
33,016 2.8

*The total number of OEF/OIF/OND Veterans who received treatment (n = 1,189,709) was used to calculate the percentage treated in any one VISN. The total may be higher than 1,189,709 unique Veterans because a Veteran can be treated in more than one VISN and each is entered separately in this table.
**Percentages reported are approximate due to rounding.
***In 2002, VA merged VISNs 13 and 14 to form VISN 23.

Diagnostic Data

  • Veterans of recent military conflicts have presented to VA for outpatient and inpatient care with a wide range of medical and psychological conditions.
  • Diagnoses have encompassed more than 8,000 discrete ICD-9-CM diagnostic codes.
  • The three most frequent diagnoses of Veterans were musculoskeletal ailments (principally joint and back disorders), mental disorders, and “Symptoms, Signs and Ill-Defined Conditions.”
  • As in other outpatient populations, the ICD-9-CM diagnostic category “Symptoms, Signs and Ill-Defined Conditions” was commonly reported. This is not a diagnosis of an unknown syndrome or unusual illness. This ICD-9-CM code includes symptoms and clinical findings that are not coded elsewhere. It is a diverse, catch-all category that is commonly used for the diagnosis of outpatient populations. It encompasses more than 160 sub-categories and primarily consists of common symptoms that do not have an immediately obvious cause during a clinic visit or consists of laboratory test abnormalities that do not point to a particular disease process and may be transient. The most frequently reported codes in this category, in order of magnitude are: General Symptoms (ICD-9-CM 780), Symptoms Involving Respiratory System and Other Chest Symptoms (ICD-9-CM 786), and Symptoms Involving Head and Neck (ICD-9-CM 784).

 

Number of Diagnoses among OEF/OIF/OND Veterans: Cumulative Numbers, FY 2002 through Specified Quarter

Specified Quarter Q3 FY14* Q4 FY14* Q1 FY15* Q2 FY15*
Total Veterans Receiving Treatment 1,089,668 1,126,173 1,158,359 1,189,709
Disease Category (ICD-9-CM Categories)
Infectious and Parasitic Diseases (001-139) 17.1 (186,647) 17.4 (195,423) 17.5 (203,145) 17.7 (211,134)
Malignant Neoplasms (140-209) 1.6 (17,281) 1.6 (18,158) 1.6 (18.965) 1.7 (19,823)
Benign Neoplasms (210-239) 8.3 (90,019) 8.5 (95,553) 8,7 (100,475) 8.9 (105,621)
Diseases of Endocrine/ Nutritional/Metabolic Systems (240-279) 36.9 (402,394) 37.4 (421,702) 37.9 (438,876) 38.5 (457,767)
Diseases of Blood and Blood Forming Organs (280-289) 4.7 (51,324) 4.8 (54,291) 4.9 (56,951) 5.0 (59,611)
Mental Disorders (290-319) 56.5 (615,922) 56.9 (640,537) 57.2 (662,722) 57.6 (685,540)
Diseases of Nervous System/ Sense Organs (320-389) 49.3 (537,074) 49.8 (560,506) 50.2 (581,598) 50.7 (603,298)
Diseases of Circulatory System (390-459) 23.6 (256,949) 23.8 (268,405) 24.1 (278,588) 24.3 (289,375)
Diseases of Respiratory System (460-519) 28.6 (311,512) 28.7 (323,698) 29.0 (336,383) 29.5 (350,934)
Diseases of Digestive System (520-579) 37.3 (406,640) 37.5 (422,181) 37.6 (436,016) 37.9 (450,661)
Diseases of the Genitourinary System (580-629) 17.4 (189,523) 17.6 (198,513) 17.8 (206,581) 18.1 (215,094)
Diseases of Skin (680-709) 24.0 (262,025) 24.5 (275,354) 24.7 (286,338) 25.0 (297,147)
Diseases of Musculoskeletal System Connective Tissue (710-739) 60.5 (659,649) 61.1 (687,723) 61.5 (711,817) 61.8 (735,582)
Symptoms, Signs and Ill Defined Conditions (780-799) 56.4 (615,064) 57.0 (641,973) 57.5 (665,903) 58.1 (690,869)
Injury/Poisonings (800-999) 31.7 (345,775) 32.1 (361,456) 32.3 (374,565) 32.6 (387,642)

* The total number of OEF/OIF/OND Veterans who received treatment was used to calculate the percentage within each disease category. A Veteran can have multiple diseases but is counted only once in any single category.

Number of Veterans with Mental Disorders* among OEF/OIF/OND Veterans Evaluated at VA Facilities

Cumulative Numbers, FY 2002 through Specified Quarter

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Specified Quarter Q3 FY14** Q4 FY14** Q1 FY15** Q2 FY15**
Number with a Possible Mental Disorder 615,922 640,537 662,722 685,540
Diagnosis (ICD-9-CM Codes)
Post-traumatic stress disorder (PTSD) (309.81)*** 337,285 351,422 364,894 364,894
Depressive Disorders (311) 270,005 282,565 294,967 308,336
Neurotic Disorders (300) 254,972 269,151 281,992 295,403
Affective Psychoses (296) 168,747 177,597 185,826 193,886
Alcohol Dependence Syndrome (303) 78,575 82,055 85,256 88,680
Nondependent Abuse of Drugs (305)**** 60,010 63,205 66,107 69,271
Special Symptoms, Not Elsewhere Classified (307) 50,623 53,196 55,733 58,398
Drug Dependence (304) 45,057 47,374 49,560 51,798
Sexual Deviations and Disorders (302) 38,089 39,185 40,746 43,308
Specific Nonpsychotic Mental Disorder due to Organic Brain Damage (310) 35,118 35,850 36,584 n/a*****
* Hospitalization and outpatient visits recorded as of March 31, 2015. These statistics for mental health problems are preliminary and will change over time because a) some Veterans may not have had an underlying mental health problem diagnosed at an initial clinical evaluation and b) Veterans may not manifest mental health problems for months to years following wartime trauma.
** The total number of diagnoses will be higher than the unique number of OEF/OIF/OND Veterans who received a diagnosis of a possible mental disorder. A Veteran can have multiple mental disorder diagnoses but is counted only once within a single condition.
*** This row of data does not include a) information on PTSD from VA’s Vet Centers, b) data from Veterans not enrolled for VA health care, or c) Veterans who were diagnosed with adjustment reaction only, ICD-9-CM 309.0.
*** Searching administrative data for the presence of one or two ICD-9-CM codes indicating PTSD (309.81) was found to be an accurate method of PTSD case identification (McCaron KM, Reinhard MJ, Bloeser KJ, Mahan CM, Kang HK. (2014). PTSD Diagnoses Among Iraq and Afghanistan Veterans: Comparison of Administrative Data to Chart Review. Journal of Traumatic Stress, 27: 626-629.)
**** This category currently excludes Veterans who have a diagnosis of a) tobacco use disorder only, ICD-9-CM 305.1; b) alcohol abuse only, ICD-9-CM 305.0; or both tobacco use disorder and alcohol abuse, ICD-9-CM 305.0 and 305.1.
***** In 2nd Qtr FY 2015, ICD-9-CM 310 was not in the top 10 mental disorder diagnosis, thus no number was reported for this quarter.

SOURCE: Epidemiology Program, Post-Deployment Health Group, Office of Public Health, Veterans Health Administration, Department of Veterans Affairs. (2015). Analysis of VA Health Care Utilization among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn Veterans, from 1st Qtr FY 2002 through 2nd Qtr FY 2015.