This study examined whether inpatient bed reductions at a Department of Vet
erans Affairs (VA) medical center increased VA patients' use of state menta
l health agency services. Veterans residing in two Connecticut cities who u
sed VA psychiatric services during fiscal years 1993 through 1998 (n = 2,94
3) were identified from computerized files. Then their records were merged
with state files. Coinciding with the time of VA bed closures, the proporti
on of VA patients who used any state services increased from 2.6%, 2.8%, an
d 2. 7% from 1993 through 1995 To 3.6%, 3.5%, and 3.6% from 1996 through 19
98 (p < .03), These changes reflect increased likelihood of state outpatien
t service use, bur not inpatient services. No statistically significant cha
nges occurred in the cost of stare services used by VA patients. Bed closur
e impart may be reflected in increased cross-system service use, which may
be a useful indicator of unmet needs resulting from system changes.