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Abstract
The number of Veterans diagnosed primarily with mental health condition is increasing rapidly. Redesigning delivery of mental health services is critical. This work investigates conceptual framework of designing panel size of providers who treat post-traumatic stress disorder (PTSD) patients. We try to find optimum panel size by using discrete event simulation in order to provide high quality of care, increase access, and reduce patient wait time.
Keywords
Mental health, continuity of care, discrete event simulation, PTSD
1. Introduction
The United States Department of Veterans Affairs exists to fulfill President Abraham Lincoln's promise "to care for him who shall have borne the battle, and for his widow, and his orphan," by providing benefits to veterans and their families. Chief among those benefits is healthcare, delivered by the Veterans Health Administration (VHA). Approximately one quarter of the US population is entitled to receive healthcare benefits from the VHA. In 2008, nearly 7.9 million veterans were enrolled in the VHA, effectively establishing it as the largest integrated healthcare network in the US. The VHA includes 153 medical centers and 1,400 sites of care, including 909 ambulatory care and community-based outpatient clinics, 135 nursing homes, 47 residential rehabilitation treatment programs, 232 Veterans Centers and 108 comprehensive home-care programs. These facilities are distributed across 21 regional health networks called Veterans Integrated Service Networks (VISNs).
1.7 million troops have been deployed in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Nearly a third of the deployed have come from the National Guard and Military Reserves, representing the heaviest reliance on the reserve component for combat operations in recent years. Although most service members return from Iraq and Afghanistan without physical injuries, many return with symptoms of PTSD or depression. Recent data from a RAND study estimated that 18.5 percent of returned troops (about 300,000 of OEF/OIF veterans) met criteria on a structured survey assessing probable PTSD or depression [1]. Wang et al. (2005) stated that sixty percent of the individuals with a high probability of having experienced a mental health problem do not use any health care services, and only the half of the remaining forty percent are given care by mental health specialists [2]. The population of military service members is more likely to have...