Utilization of Veterans ' Health Services for Substance Abuse: A Study of Aging Baby Boomer Veterans

Abstract: The purpose of this chapter is to determine whether there were changes in veterans ' utilization of substance abuse services as they became older. The study used national Department of Veterans Affairs (VA) inpatient utilization data from fiscal years 1988, 1991, 1994, and 1998, and national outpatient data from fiscal year 1998. Observations were selected if the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for substance abuse or dependence, intoxication, or alcohol or drug psychoses were identified in any of the 10 diagnosis fields for the inpatient stay or outpatient visit. Observations were also identified as primary or secondary substance-related diagnoses. Utilization of inpatient substance use and non-substance use services by age cohorts, including baby boomers (i.e., those aged 30 to 44 years in 1992), was examined for all veterans with substance use diagnoses in each year, and utilization of outpatient substance use services was studied for 1998. Relative to other age groups defined for 1992, the proportionate use of VA inpatient substance use services by baby boomers remained relatively constant or increased over the years studied, while their proportionate use of other inpatient services increased. Results for the 1 year of outpatient utilization data that were available showed similar distributions to those from the comparable inpatient year. Therefore, veteran substance abusers from the baby boomer generation continue to occupy the largest proportion of VA substance abuse services, and there is little evidence of declining need for treatment or "aging out " among this group of substance-using veterans