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Predictors of mental and physical health service utilization among Vietnam veterans.
Authors:Maguen  Shira; Schumm  Jeremiah A; Norris  Rebecca L; Taft  Casey; King  Lynda A; King  Daniel W; Litz  Brett T
Abstract:This study investigated predictors of mental and physical health care service utilization among 1,632 male (n = 1,200) and female (n = 432) Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. Using Anderson's theory as a model (Anderson & Bartkus, 1973), the authors examined both direct and mediated relationships among predisposing factors (i.e., age, marital status, and combat exposure), enabling factors (e.g., household income and insurance), and need factors (e.g., medical and psychological symptomatology) and physical and mental health care utilization outcomes. Need factors were the most consistent and strongest mediators of predisposing variables for both physical and mental health care service utilization, although there were differences between male and female veterans. For men, combat exposure indirectly predicted mental health care utilization through the need variables (with the effects of posttraumatic stress disorder being greatest). For women, physical health problems mediated the relationship between combat exposure and physical health outpatient care utilization. These findings have implications for screening and outreach efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)
Keywords:posttraumatic stress disorder (PTSD)  veterans  service utilization  physical health utilization  mental health utilization  predisposing factors  enabling factors  need factors
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