An influx of returning Iraq and Afghanistan veterans with injuries from multiple tours overseas and higher pension and compensation claims have substantially pushed up federal spending on veterans at the same time the number of veterans has declined in southwest Ohio, a Dayton Daily News analysis shows.

The newspaper analysis revealed some of the costs involved in treating those injured during the 10 years of war.

“We have a lot of veterans today with very serious injuries,” said Mike McKinney, a spokesman with the Ohio Department of Veterans Services.

Overall, VA spending reached $626.5 million in 2011 in the region, versus $353.5 million five years earlier, the analysis shows. With data from the Ohio Department of Veterans Services, the Dayton Daily News reviewed federal spending in eight counties: Montgomery, Miami, Greene, Clark, Warren, Champaign, Butler and Preble.

In the eight-county region, the number of veterans reached about 129,000 last year, or a drop of about 20,000 since 2006, figures show.

At the Dayton Veterans Affairs Medical Center, veterans back from overseas combat tours have put demands mostly on primary health care and mental health services, VA officials said.

Treating Iraq and Afghanistan veterans can be complicated because many have deployed multiple times and face multiple problems, such as blast injuries, back problems and post-traumatic stress disorder, said William Wall, director of the Dayton VA’s Freedom Center, the first stop for post-9/11 veterans who need services from the VA.

At the same time, VA rule changes that permit more Vietnam-era soldiers to claim exposure to Agent Orange have caused compensation costs to rise, officials said.

The recession and subsequent weak economy also has caused some veterans to lose their jobs and apply for VA compensation or pension benefits while county veteran service officers connect more veterans to claims, officials said.

Ohio had 867,240 veterans through last year, the sixth largest veterans’ population in the nation while the VA pumped $5.7 billion into the state’s economy. The state ranks eighth in the nation for VA expenditures per veteran at $6,610 last year, figures show.

In Montgomery County, the VA spent $6,112 per veteran in 2011 versus $3,210 five years earlier. The veteran population was 44,648 last year compared to 53,302 in 2006.

Even while the number of veterans has declined, those walking into the Dayton VA for assistance has climbed steadily. In 2008, 35,027 sought assistance of some kind and that number will rise to nearly 40,000 this year, officials said. Since Oct. 1, the Freedom Center has handled the needs of 2,400 from Iraq and Afghanistan alone.

The number of veterans needing help is expected to grow at the Dayton VA because many wait years before asking for services, officials said.

To cope with demands for more services from post-9/11war-related needs, the Dayton VA has focused on the health of women veterans, job retraining, combating homelessness and home-based health care, officials added.

“That’s where there’s been a lot of growth and expansion,” said Dr. Victor Knapp, a psychiatrist and chief of mental health services at the Dayton VA.

To treat all those veterans and meet VA initiatives, the Dayton VA’s budget will climb to $337 million this year, a $10 million increase from the prior year. The amount pays for operations at neighboring outpatient clinics in other counties, too.

The VA is trying to meet demands, but more staff is needed in some areas while less in-patient care is available, said Thomas Bush Jr., an Air Force veteran from Riverside.

“They’re doing what they can,” said Bush, active in a PTSD support group at the Dayton VA. “They’re doing less in-patient care. They’ve gone to more outpatient care and vets have to struggle to get into programs they do have available.”

VA staff members have felt the pinch, too, Bush said.

“The few I’ve talked to are stressed with the amount of patients they have to deal with in the time they have to deal with them,” he said.

Dayton VA officials say they’ve increased mental health workers and focused more on outpatient or residential care, following a nationwide trend to help veterans integrate back into society.

Last year, more than 2,300 veterans of all eras were treated for PTSD. The Dayton VA said this year it added at least eight mental health workers to a staff of at least 180 employees to handle the demand. The Dayton VA has nearly 2,200 employees.

They’ve embraced more in-depth treatment of mental health issues, such as post-traumatic stress, which require longer sessions but reduce how many clients a psychologist can see in a day, he said. Even so, Knapp said, the VA can see a patient the same day if needed.

The VA added five health care workers with mental health specialties in primary care to ease the stigma of veterans who may not otherwise seek counseling, he said.

“There are patients who may be OK with seeing someone from mental health care as long as it’s in the primary care clinic,” he said. “It’s far less daunting or stigmatizing to them than to go to the mental health clinic.”

VA officials acknowledged the use of 500 patient beds has changed, but the total available has remained consistent in recent years with 265 nursing home beds, 120 acute care beds and 115 domiciliary beds for on-campus treatment and rehabilitation programs.