Postdeployment Health Reassessment: a sustainable method for brigade combat teams.

Division Surgeon, Third Infantry Division, Building 620, Fort Stewart, GA 31314, USA.
Military medicine (Impact Factor: 0.77). 11/2007; 172(10):1017-23.
Source: PubMed

ABSTRACT The Postdeployment Health Reassessment (PDHRA) was mandated in 2006 and the 3rd Infantry Division was the first unit to perform a large-scale implementation. This article outlines a reproducible model for conducting PDHRA using only existing resources.
The PDHRA (DD 2900) screening and referral processes are reviewed and data on positive screens are reported.
Of the 12,817 soldiers who participated in the mass screening, 1,460 (11.4%) were referred for behavioral health, 815 (6.4%) for primary care, 71 (0.01%) for specialty services, and 9 (0.001%) for emergency services. Consult requests were higher in maneuver brigades than in support units (12.1% versus 8.6% for behavioral health and 6.9% versus 4.4% for primary care referrals). All (1,460, 100%) of the behavioral health consults were completed on-site and the unit incurred no additional financial cost in conducting this process.
This method for performing a large-scale implementation of the PDHRA provides a flexible, efficient, and cost-effective process that could be implemented at the brigade combat team level without difficulty and in most locations without significant impact on other medical demands.

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    ABSTRACT: Vanderbilt's study used de-identified Service member (SM) PDHA and PDHRA responses and Military Health System contacts; anonymous SM surveys; analysis of de-identified assessment recordings; and assessment site observations and interviews with key unit and program administrators. Key findings included the PDHRA was associated with increased medical contacts regardless of referral status; SM responses on the assessment were the primary factor in clinician queries and referral decisions; clinician documentation and referral decisions were less consistent than SM responses; assessments conducted telephonically led to similar findings as those conducted face-to-face regarding clinician concerns, but resulted in fewer referrals; factors in the context of the assessment were associated with SM openness; clinicians could benefit from PDHRA-specific training; educational resources were valued by the SM but not commonly provided; and the additional questions about alcohol use did not provide added value. Recommendations were provided.


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