Prior research suggests that a significant number of veterans with posttraumatic stress disorder (PTSD) do not have this diagnosis recognized in the electronic health record (EHR). Unfortunately, such diagnostic errors can lead to improper allocation of already scarce health care services and resources. In this study, we examined concordance between PTSD diagnoses in the Veterans Affairs (VA) EHR and PTSD diagnoses based on a semistructured diagnostic interview and mental health service use in a sample of veterans (N = 1,299) enrolled in VA healthcare. Results from negative binomial regressions showed that veterans with PTSD based on the diagnostic interview and the EHR (true positives) used the most mental health care services. There were no significant differences between those without PTSD based on the interview and the EHR (true negatives) and those with PTSD based on interview that was not recognized in the EHR (false negatives) on total nonemergent outpatient mental health visits. However, veterans in the false negative group had more mental health-related emergent care visits (i.e., emergency room, urgent care, hospitalization) than veterans in the true negative group. Our findings suggest that veterans with PTSD who are not coded as such in the EHR may not be utilizing needed outpatient care but are seeking and receiving costly emergent care. Thus, accurate recognition of PTSD in the EHR is essential for connecting patients to outpatient mental health services. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译：

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PTSD的电子记录与临床访谈诊断之间的差异：精神卫生保健利用的差异。

先前的研究表明，大量患有创伤后应激障碍 (PTSD) 的退伍军人没有在电子健康记录 (EHR) 中确认这种诊断。不幸的是，此类诊断错误可能导致对已经稀缺的医疗保健服务和资源的不当分配。在这项研究中，我们检查了退伍军人事务部 (VA) EHR 中的 PTSD 诊断与基于半结构化诊断访谈和心理健康服务使用的退伍军人事务部 (VA) 医疗保健机构样本中的 PTSD 诊断之间的一致性。负二项式回归的结果显示，基于诊断访谈和 EHR（真阳性）的 PTSD 退伍军人使用最多的心理保健服务。在非紧急门诊心理健康就诊中，基于访谈和 EHR（真阴性）没有 PTSD 的患者与基于 EHR（假阴性）未识别的访谈的 PTSD 患者之间没有显着差异。然而，假阴性组的退伍军人比真阴性组的退伍军人有更多的与心理健康相关的急诊就诊（即急诊室、紧急护理、住院）。我们的研究结果表明，未在 EHR 中编码的 PTSD 退伍军人可能没有使用所需的门诊护理，但正在寻求和接受昂贵的紧急护理。因此，准确识别 EHR 中的 PTSD 对于将患者与门诊心理健康服务联系起来至关重要。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）。