Evaluating chaplaincy utilization in a suicide-risk-stratified Veterans Affairs patient sample

Although chaplaincy is a key part of the Department of Veterans Affairs' (VA) healthcare services, few studies have investigated how classified suicide risk impacts this service utilization. Filling this gap, this study evaluates utilization patterns in a suicide-risk-stratified national sample of VA patients who died by suicide (cases), as well as suicide risk-matched patients (controls) who did not die by suicide in 2017-2018. Given overdispersion and data sparsity, the study used Bayesian Zero-Inflated Negative Binomial regression and evaluated group and risk-tier status associations. Chaplaincy utilization proportionally declined along with suicide risk; high-risk patients received significantly more care than moderate-risk patients, while moderate-risk patients received significantly more care than low-risk patients. Case and control differences were not significant. Findings support broader pattern of higher-risk patients receiving more care in general. Future investigations that include unstructured data could help contextualize case and control differences.