Follow-Up Healthcare Inspection. VA's Role in Ensuring Services for Operation Enduring Freedom/Operation Iraqi Freedom Veterans after Traumatic Brain Injury Rehabilitation

摘要

In a July 2006 report, the VA Office of Inspector General (OIG), Office of Healthcare Inspections (OHI) described the health status of and services provided for a group of service members and veterans who had received inpatient rehabilitative care in VA facilities for traumatic brain injury (TBI) sustained during or after tours of duty in Iraq or Afghanistan. At the request of the Chairman of the Senate Committee on Veterans' Affairs, the OIG conducted a follow-up assessment to determine the extent to which the Veterans Health Administration (VHA) maintains involvement with these same individuals to ensure that their health care needs are met. OHI inspectors extracted data on VA health care utilization from electronic medical records. Interviews with patients and/or family members were conducted by telephone or in person, and all participants were given explicit permission to decline participation. Interviewers inquired about changes since the initial interview in 2005. Specifically, questions pertained to education or training received, current employment or student status, military status, marital status, living situation, driving status, sources of health care, role of VA in health care, and presence of behavioral problems. OHI physician, nursing, and social work staff reviewed each case to establish whether patients had significant unmet needs. Three years after completion of initial inpatient rehabilitation for TBI, many of these patients continue to have significant disabilities. VHA and Veterans Benefits Administration support for TBI patients is extensive. While case management has improved, long-term case management is not uniformly provided for these patients, and significant needs remain unmet. OIG will continue to monitor VHA's progress toward achieving consistent delivery of case management services for this select group of injured veterans.