Cumulative from 1 st Qtr FY 2002 through 1 st Qtr FY 2014 (October 1, 2001 December 31, 2013) Released March 2014

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1 Report on VA Facility Specific Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) erans Diagnosed with Potential or Provisional PTSD Cumulative from st Qtr FY 2002 through st Qtr FY 204 (October, 200 December 3, 203) Released March 204 Epidemiology Program Post-Deployment Health Group Office of Public Health erans Health Administration Department of erans Affairs

2 Table of Contents Introduction... Background... Data Sources... 2 OEF/OIF/OND eran Roster... 2 VHA Health Care Utilization Records... 2 Distribution of erans by Diagnostic Code and Facility... 3 Summary... 3 Table of OEF/OIF/OND erans with Potential or Provisional PTSD Using VA Facilities... 4 OEF/OIF/OND erans Coded with Potential or Provisional PTSD Cumulative from FY 2002 st Qtr FY 204, Released March 204 ii

3 Introduction This quarterly report on erans who have used VA health care and who served in Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), or Operation New Dawn (OND), shows the number and distribution of these erans diagnosed with a potential or provisional diagnosis of Post-Traumatic Stress Disorder (PTSD). This report includes only those erans diagnosed at a VA Medical Center (VAMC), erans Integrated Service Network (VISN), or Center. This report is created by linking the DoD roster of returning erans to VA s electronic inpatient and outpatient health records and Center records. Suggested citation: Epidemiology Program, Post Deployment Health Group, Office of Public Health, erans Health Administration, Department of erans Affairs. (204). Report on VA Facility Specific Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn erans Coded with Potential or Provisional PTSD, from st Qtr FY 2002 through st Qtr FY 204. Washington, DC: Author. Retrieved from (URL) Check for updates. Background This report is provided in response to a Government Accountability Office (GAO) request in 2004 that VA enumerate the total number of OEF, OIF, and OND erans who were diagnosed with PTSD by VISN and specific VAMC using VA inpatient and outpatient records. GAO also requested that this information be aggregated with Center utilization data. The erans Health Administration (VHA) prepared an initial report in October 2004 for health care utilization during FY 2004 (October, September 30, 2004). This current report covers VA health care data for FY 2002 through st Qtr FY 204 (October, 200 December 3, 203). OEF/OIF/OND erans Coded with Potential or Provisional PTSD Cumulative from FY 2002 st Qtr FY 204, Released March 204

4 Data Sources OEF/OIF/OND eran Roster Since October 2003, the Department of Defense (DoD) Defense Manpower Data Center (DMDC) has sent the VA, Office of Public Health, Post-Deployment Health Group, Epidemiology Program (EP), a periodically updated personnel roster of troops who participated in OEF/OIF/OND and who separated from active duty and became eligible for VA benefits. In September 2004 and April 203, DMDC revised procedures for creating periodic updates of the roster. DMDC now utilizes additional service branch information from service branches of erans who served in OEF/OIF/OND troops to update the roster. Based on the latest DMDC file received on January 0, 204, there are a total of,759,433 unique OEF/OIF/OND erans (including 5,838 erans who died in-theater) who, as of November 203, separated from active duty following a deployment. For each eran, their demographic (social security number, name, date of birth, gender, education, etc.) and military service specific data (branch, rank, unit component, deployment dates, etc.) were included in the record. Beginning in 3 rd Qtr FY 2009 (April, June 30, 2009), erans who died in-theater are included in both the DMDC total roster and health care utilization data because this is a cumulative report going back to 2002, and, due to the duration of the OEF/OIF/OND conflict and repeated deployments, a certain number of these erans may have accessed VA health care services for the evaluation and/or treatment of PTSD. VHA Health Care Utilization Records The roster was checked against VA s inpatient (PTF) and outpatient (OPC) electronic patient records available through December 3, 203 to identify those who had sought treatment in VA facilities and to identify the International Classification of Diseases, 9 th Revision, Clinical Modification (ICD-9-CM) diagnostic codes used to describe the visits. These are administrative data and are not based on a review of patient records. For the purpose of this report, a search was conducted of individual health care utilization records during FY 2002 st Qtr FY 204 following first deployments in Iraq or Afghanistan. For identification of a potential or provisional PTSD patient, we used ICD- 9-CM, The Center counts were based on the data provided to EP on March 6, 204 by the Readjustment Counseling Service (RCS). The RCS staff matched the DMDC roster with Center users records through st Qtr FY 204. The Epidemiology Program does not make any modifications to the data provided by RCS. OEF/OIF/OND erans Coded with Potential or Provisional PTSD Cumulative from FY 2002 st Qtr FY 204, Released March 204 2

5 Distribution of erans by Diagnostic Code and Facility A eran is counted only once in any facility specific category. For example, a eran who received health care from two or more medical centers within the same VISN was counted once for that VISN. Likewise, a eran who used services across two or more VISN facilities and a Center was counted only once for the national overall total. The number for Primary indicates the total number of unique erans whose primary reason for the inpatient or outpatient visit was for treatment or evaluation of PTSD. The number for Any indicates the total number of unique erans coded with PTSD, whether or not the primary reasons for the inpatient or outpatient visit was for treatment or evaluation of PTSD. Both Primary and Any categories may include a potential or provisional diagnosis. Summary A query of VHA health care utilization databases using the November 203 DMDC roster yielded a total of 3,688 OEF/OIF/OND erans coded with PTSD at a VAMC and 80,95 erans who received Center service for PTSD. Of these, 257,343 were seen only at a VAMC; 26,606 only at a Center; and 54,345 were seen at both facilities. In summary, based on the electronic patient records available through December 3, 203, a grand total of 338,294 OEF/OIF/OND erans were seen for potential or provisional PTSD at VHA facilities following their return from Iraq or Afghanistan. OEF/OIF/OND erans Coded with Potential or Provisional PTSD Cumulative from FY 2002 st Qtr FY 204, Released March 204 3

6 OEF/OIF/OND erans with a Diagnosis of Potential or Provisional PTSD Using VA Facilities Table : Number and Distribution of Unique OEF/OIF/OND erans with Potential or Provisional PTSD Utilizing VA Facilities during FY st Qtr FY 2040F VISN-Facility Primary 2 Any 3 Outpatients -Primary 5 Outpatients- Primary 5 PTSD Outreach Others -BEDFORD 6 359,40,594,44, ,739 -BOSTON ,93 3,735 3,27 3,86, ,006 4,593 -MANCHESTER..,34,488,34, ,374,820 -NORTHAMPTON ,50,693,578, , ,958 -PROVIDENCE ,502,670,506, ,445,98 -TOGUS 84 97,639,826,644,84,93 982,3 2,370 -WEST HAVEN ,224 3,426 3,225 3, ,37 3,75 -WHITE RIVER JCT 79 2,28,476,286,503, ,254 VISN 972 2,23 3,40 4,53 3,56 4,622 6,79 3,780 3,460 7,329 2-UPSTATE N.Y. HCS ,055 7,783 7,074 7,828 2,09 7,027 8,369 8,85 VISN ,055 7,783 7,074 7,828 2,09 7,027 8,369 8,85 3-BRONX 78 87,345,50,350, ,622 3-EAST ORANGE ,358 3,706 3,366 3,737,836 22,559,629 4,878 3-MONTROSE VA HUDSON HCS NY 05 69,37,407,320, ,546 3-N.Y. HARBOR HCS ,983 3,392 2,990 3,436 84,294,308 3,788 3-NORTHPORT 0 239,409,596,4, ,665 VISN 3 54,23 9,532 0,526 9,549 0,593 3,434 24,87 4,050 2,244 4-BUTLER CLARKSBURG 6 7,49,274,52, , ,399 4-COATESVILLE 3 296,494,572,53,67...,67 4-ERIE JAMES E VAN ZANDT VAMC 36,95,369,95, ,45 4-LEBANON ,875 2,029,880 2,048 49, ,263 4-PHILADELPHIA ,536 3,930 3,538 3, ,38 Grand 4 To protect the privacy of erans, frequencies of fewer than 0 individuals are not reported. 2 The number for Primary indicates the total number of unique erans whose primary reason for the inpatient or outpatient visit was for treatment or evaluation of PTSD. 3 The number for Any indicates the total number of unique erans with PTSD whether or not the primary reasons for the inpatient or outpatient visit was for treatment or evaluation of PTSD. 4 The number for Grand (n= 338,294) indicates the sum of Any Patients (n=3,688) and Center PTSD (n=80,95) after excluding duplicates (n=54,345). OEF/OIF/OND erans Coded with Potential or Provisional PTSD Cumulative from FY 2002 st Qtr FY 204, Released March 204 4

7 VISN-Facility Primary 2 Any 3 Outpatients -Primary 5 Outpatients- Primary 5 PTSD Outreach Others Grand 4 4-PITTSBURGH-UNIV DR ,322,577,368, ,9 65 2,477 4-WILKES BARRE 38 73,48,69,484,704 62, ,043 4-WILMINGTON 23,070,7,070,7 569,026 48,426 VISN 4 57,607 2,843 4,205 2,858 4,324 3,854 6,68 2,454 6,04 5-BALTIMORE ,355 2,72 2,365 2, , ,064 5-MARTINSBURG ,67 2,276 2,68 2, ,349 5-WASHINGTON ,780 4,359 3,79 4,407,326 2, ,09 VISN ,847 8,80 7,86 8,86 2,282 4,647,264 9,788 6-ASHEVILLE-OTEEN ,069,227,079,265...,265 6-BECKLEY DURHAM ,8 3,22 2,89 3, , ,657 6-FAYETTEVILLE NC ,283 6,058 5,302 6,094,34 25, ,889 6-HAMPTON ,968 3,443 2,970 3, , ,803 6-RICHMOND ,09 3,543 3, 3, , ,950 6-SALEM ,486,687,526, ,775 6-SALISBURY ,39 5,244 4,397 5, , ,660 VISN 6,227 2,332 9,894 22,479 9,923 22,659 5,062 45,557 2,74 25,37 7-ATLANTA ,447 6,066 5,450 6,088,002 3, ,53 7-AUGUSTA ,523 2,775 2,537 2, ,858 7-BIRMINGHAM 243 3,96 3,53 3,96 3, , ,795 7-CHARLESTON ,393 5,007 4,397 5,040,65 9, ,585 7-COLUMBIA SC ,572 4,992 4,577 5, , ,423 7-DUBLIN. 57,794,98,794, ,034 7-MONTGOMERY ,783 4,272 3,804 4, ,369 7-TUSCALOOSA ,774,83,793,864...,864 VISN ,40 25,067 27,639 25,076 27,745 3,950 20,988,647 29,224 8-BAY PINES ,98 3,239 2,988 3, , ,434 8-MIAMI ,005 3,303 3,04 3, ,360,385 3,784 8-N FL/S GA HCS ,420 5,045 4,43 5,092,3 5, ,578 8-ORLANDO FL VAMC.. 4,555 5,069 4,555 5, , ,388 8-SAN JUAN PR ,986 2,334,987 2, ,293,520 2,595 8-TAMPA ,330 4,25 3,355 4, ,563 8-W PALM BEACH 8 306,673,839,676, ,964 VISN ,690 9,652 22,038 9,670 22,330 4,946 8,063 4,54 24,078 9-HUNTINGTON. 56,065,70,065,72 433,505 94,432 9-LEXINGTON-LEESTOWN ,05 2,286 2,0 2, ,42 9-LOUISVILLE 7 292,89 2,28,828 2, , ,250 9-MEMPHIS ,02 2,407 2, 2, , ,843 9-MOUNTAIN HOME ,52 2,750 2,54 2, ,0 9-VA MID TENN HCS NASH TN 473,064 5,833 6,427 5,854 6,546,058, ,966 VISN ,344 4,673 6,268 4,70 6,437 3,268 8, ,84 0-CHILLICOTHE 9 36,67,305,8,37...,37 0-CINCINNATI ,37 2,528 2,320 2, , ,632 OEF/OIF/OND erans Coded with Potential or Provisional PTSD Cumulative from FY 2002 st Qtr FY 204, Released March 204 5

8 VISN-Facility Primary 2 Any 3 Outpatients -Primary 5 Outpatients- Primary 5 PTSD Outreach Others Grand 4 0-CLEVELAND-WADE PARK ,42 3,789 3,423 3, ,99,77 3,999 0-COLUMBUS-IOC..,754 2,02,754 2, ,245 0-DAYTON 5 355,735,972,750 2, ,08 VISN 0 485,338 9,573 0,642 9,586 0,739,257 5,395 2,784,89 -ANN ARBOR HCS ,402 2,709 2,44 2, ,845 -BATTLE CREEK ,696 2,962 2,708 2, , ,297 -DETROIT VAMC ,489,907,502,96 555, ,229 -ILLIANA HCS DANVILLE IL 7 96,795 2,092,797 2,05 363,528,48 2,249 -INDIANAPOLIS-0TH ST ,325 2,704 2,339 2, , ,89 -NORTHERN INDIANA HCS 54 77,595,807,603, , ,932 -SAGINAW. 26,82 2,033,82 2, ,097 VISN 662,50 2,608 4,260 2,622 4,344 2,374 7,574 2,42 5,237 2-HINES ,655 2,824 2,663 2, ,04 2-IRON MOUNTAIN MADISON 88 30,486,68,497, ,399,96 2,507 2-MILWAUKEE ,8 3,092 2,86 3, ,29 2-NORTH CHICAGO ,572,854,594, ,086 2-TOMAH ,496,660,500, ,750 2-VA CHICAGO HCS ,90 2,98,95 2, ,405 VISN 2 582,642,68 2,46,92 2,527 2,755 32,737 2,967 3,933 5-VA HEARTLAND-E VH MO ,803 5,384 4,86 5, , ,80 5-VAMC HEARTLAND-W KANSAS MO 828,50 7,8 8,784 7,977 9,004,04 9,626,32 9,45 VISN 5,079 2,88 2,384 3,893 2,54 4,5,843 2,904 2,73 4,97 6-ALEXANDRIA ,032 2,288 2,046 2, ,363 6-FAYETTEVILLE AR ,378 2,546 2,387 2, ,76 6-GULF COAST HCS ,344 3,734 3,352 3,765,094 3, ,36 6-HOUSTON ,690 6,68 5,720 6, ,460 6-JACKSON ,50,762,508, , ,897 6-LITTLE ROCK ,694 3,96 3,77 4, ,90 6-MUSKOGEE ,05 2,27 2,3 2, ,5 6-OKLAHOMA CITY ,345 3,878 3,363 3, ,80 6-SHREVEPORT ,066 2,243 2,085 2, , ,69 6-SOUTHEAST LA HCS 2,474 2,774 2,474 2, , ,66 VISN 6,782 3,522 26,677 29,375 26,732 29,597 5,255 7,777 2,055 3,758 7-DALLAS ,58 7,840 7,67 7,885,228, ,403 7-SAN ANTONIO ,7 7,597 6,78 7,642,954 5, ,579 7-TX VALLEY COASTAL BEND HCS..,99 2,230,99 2, ,230 7-VA CENTRAL TEXAS HCS ,20 0,307 9,230 0,346 2,776 40,57 2,448,754 VISN ,6 23,78 25,82 23,203 25,924 6,82 47,584 3,644 28,640 8-AMARILLO HCS 62,393,489,393, ,635 8-EL PASO HCS.. 2,30 2,758 2,30 2, , ,876 8-NEW MEXICO HCS ,063 3,305 3,065 3, ,686 8-NORTHERN ARIZONA HCS 6 999,7 999, ,222 OEF/OIF/OND erans Coded with Potential or Provisional PTSD Cumulative from FY 2002 st Qtr FY 204, Released March 204 6

9 VISN-Facility Primary 2 Any 3 Outpatients -Primary 5 Outpatients- Primary 5 PTSD Outreach Others Grand 4 8-PHOENIX ,647 6,205 5,660 6,257,0 3, ,6 8-SOUTHERN ARIZONA HCS ,576 2,924 2,598 2, ,555,246 3,257 8-WEST TEXAS HCS 2,55,276,55, ,360 VISN 8 762,544 6,05 7,773 6,063 7,854 3,793 6,439 2,927 9,29 9-CHEYENNE 7,359,499,359, ,738 9-DENVER ,944 8,027 6,964 8,079,702 9,538,88 8,686 9-FORT HARRISON ,86 2,422 2,89 2, , ,762 9-GRAND JUNCTION SALT LAKE CITY HTHCARE ,355 3,770 3,358 3, ,797,005 4,64 9-SHERIDAN ,2 984,28...,28 VISN 9 80,533 4,359 6,243 4,377 6,3 4,052 4,789 3,70 7, ALASKA HCS & RO..,239,427,239, ,04 2,844, BOISE 57 23,0,352,08, ,5, PORTLAND ,669 5,274 4,676 5,325,008,357,006 5, PUGET SOUND HCS ,236 8,0 7,307 8,95 2, 0,263 2,789 9, S.ORG REHAB WHITE CITY SPOKANE 58 59,439,647,442, ,945 2,24 20-VA ROSEBURG HCS ,285,406,350, , , WALLA WALLA,044,85,044, ,88 VISN 20,053,828 7,339 9,452 7,389 9,543 6,63 9,802 2,500 22,095 2-CENTRAL CALIFORNIA HCS 9 22,509,720,50, , ,878 2-HONOLULU 36 82,935 2,76,938 2, ,572 3,353 2,442 2-MANILA NCHC MARTINEZ ,003 4,862 4,009 4,885,290 2,372,09 5,39 2-PALO ALTO-PALO ALTO ,875 4,278 3,904 4, ,335,920 4,745 2-SAN FRANCISCO 46 83,74,905,744, ,060 2-SIERRA NEVADA HCS 43 49,03,205,05, ,524 60,36 VISN 2 478,434 3,433 5,78 3,460 5,367 3,66 4,060 7,429 6, GREATER LA HCS ,48 6,358 5,486 6,422,300 3,86 2,50 6, LOMA LINDA ,330 5,28 4,337 5,97,238 0,060,04 5, VA LONG BEACH HCS CA ,284 4,73 4,290 4, ,76 5,84 22-VA SAN DIEGO HCS CA ,62 7,626 6,629 7,683,394 8,429 4,573 8, VA SOUTHERN NEVADA HCS ,49 2,420 2,60 2, ,69 VISN ,3 2,358 24,284 2,387 24,448 5,02 22,895 0,085 26, FARGO 50 29,479,763,480, , , FORT MEADE MINNEAPOLIS ,448 2,924 2,452 3,00 724, ,47 23-SIOUX FALLS ,06 893,07 478,485,55, ST CLOUD 65 22,792,884,794,894..., VA NEB-WESTERN IA HCS ,72 6,758 6,78 6,80,22 3,456,457 7,28 OEF/OIF/OND erans Coded with Potential or Provisional PTSD Cumulative from FY 2002 st Qtr FY 204, Released March 204 7

10 VISN-Facility Primary 2 Any 3 Outpatients -Primary 5 Outpatients- Primary 5 PTSD Outreach Others Grand 4 Unique Counts VISN ,586 2,55 4,02 2,52 4,6 2,908 9,45 4,75 5,220 5,735 36,05 280,85 30,230 28,04 3,688 80,95 360,695 96, ,294 5 In 2002, VA merged VISNs 3 and 4 to form VISN 23. OEF/OIF/OND erans Coded with Potential or Provisional PTSD Cumulative from FY 2002 st Qtr FY 204, Released March 204 8

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