PREDICTORS OF SERVICE UTILIZATION IN VETERANS WITH BIPOLAR DISORDER -A PROSPECTIVE-STUDY

This study prospectively followed 103 bipolar patients enrolled in a V A treatment program for I year. Mental health service utilization was recorded and aggregated using the VA Cost Distribution Report. We hypo thesized that previously reported predictors of disease severity would also predict service utilization, and that several other predictors o f service utilization might also be identified. Analyses indicated tha t only the presence of a major affective episode at clinic intake and a recalled history of childhood physical abuse predicted mental health service utilization. Contrary to expectations, previously reported pr edictors of disease severity were not significant predictors. Implicat ions for the study of economic outcome are discussed. In particular, w e propose that economic outcome is a complex function of both patient and system factors, rather than simply being passively driven by disea se severity. (C) 1997 Elsevier Science B.V.