Neurocognitive function and medical care utilization in Veterans treated for substance use disorder

Area of Science:

• Neuroscience
• Health Services Research
• Psychiatry

Background:

• Veterans with substance use disorder (SUD) face high risks of cognitive impairment from substance abuse and traumatic brain injury (TBI).
• Cognitive deficits can increase SUD relapse risk and reduce self-care adherence, leading to greater healthcare system reliance.
• The relationship between neurocognitive function and healthcare utilization in Veterans receiving SUD treatment is not well understood.

Purpose of the Study:

• To investigate the association between neurocognitive performance and healthcare utilization among Veterans with SUD.
• To examine if cognitive function predicts engagement with Veterans Health Administration (VHA) healthcare services, using VHA care costs as a proxy.

Main Methods:

• Assessed neurocognitive performance in 76 Veterans with SUD using the CNS-Vital Signs computerized testing battery.
• Correlated cognitive test results with outpatient and inpatient/residential care costs estimated by the VHA Health Economics Resource Center.

Main Results:

• Overall neurocognitive performance negatively correlated with total VHA healthcare costs, including SUD-related and non-mental health care costs, after controlling for age.
• Higher scores on the Barratt Impulsiveness Scale positively correlated with total VHA care costs.

Conclusions:

• In Veterans receiving SUD care, poorer neurocognitive function and higher impulsivity are linked to increased VHA healthcare utilization.
• Veterans with SUD and lower cognitive performance may be at higher risk for ongoing health issues requiring significant healthcare engagement.
• Cognitive rehabilitation programs, adapted from TBI and neurological condition treatments, may improve health outcomes for Veterans with SUD.