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General and Specialist Health Care Utilization in Military Children of Army Service Members Who Are Deployed

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Military Deployment and its Consequences for Families

Part of the book series: Risk and Resilience in Military and Veteran Families ((RRMV))

Abstract

This paper on children in Army families is the first to examine objective, non-self-report, measures of all health care utilization inclusive of prescription medications among children experiencing the deployment of a parent. It employs a quasi-experimental, pre–post, non-equivalent group design to compare changes in pediatric health care utilization. Multivariate difference-in-differences regression models isolate the effect of deployment on change in service usage comparing a period prior to deployment to a period starting with the parent’s deployment. The proportion of children using any specialist office visits showed a net increase, while the proportion with any generalist office visits showed a net decline. Post-hoc analysis revealed that these pediatric specialist visits were predominantly, not exclusively, for psychiatric-type services. There also was, in users of antidepressants prescriptions, a 28 % relative increase in children under age 12 and 18 % relative increase in children age 12 years and older. Policy and procedures to support the increased care coordination required of both primary care providers and parents of children who make use of psychiatric specialty services is important, especially since pediatric providers are often in the civilian, and not military, sector.

Author Note

This paper was delivered at the 2011 International Research Symposium of the Military Family Research Institute. The opinions or assertions herein are those of the authors and do not necessarily reflect the view of the United States Department of Defense.

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Acknowledgment

This paper is based upon work supported by TRICARE Management Agency through a Program Support Center contract to The CDM Group, Inc. with subcontract to Brandeis University (Contract Number: HHSP23320045009XI, Task Order Number: HHSP233200800001T). We wish to acknowledge the contributions and able guidance of the Task Order Officer, Thomas Williams, PhD, and Ms. Pat Golson of HPA&E, and the invaluable assistance of Ms. Wendy Funk and Ms. Laura Hopkins of Kennell and Associates, and Jennifer MacLeod of Altarum Institute who prepared the project’s data extracts. Finally, the project team benefited from the collaboration of other project staff, including Christopher Tompkins, PhD, Jennifer Perloff, PhD, Grant Ritter, PhD, and Galina Zolotusky at Brandeis University and Michael Keane, PhD and Robert O’Brien at The CDM Group, Inc.

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Authors and Affiliations

  1. Heller School for Social Policy & Management, Brandeis University, 415 South Street, MS 035, Waltham, MA, 02454, USA

    Mary Jo Larson Ph.D., M.P.A., Beth A. Mohr M.S. & Laura Lorenz Ph.D., M.Ed.

  2. The CDM Group, Inc., 7500 Old Georgetown Rd. Suite 900, Bethesda, MD, 20814, USA

    Candice Grayton M.P.H.

  3. Methods, Measures, and Analyses, Defense Health Cost Assessment and Program Evaluation, TRICARE Management Activity, 7700 Arlington Blvd, Suite 5101, Falls Church, VA, 22042-5101, USA

    Thomas V. Williams Ph.D., M.S. (Director)

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  1. Mary Jo Larson Ph.D., M.P.A.
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  2. Beth A. Mohr M.S.
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  3. Laura Lorenz Ph.D., M.Ed.
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  4. Candice Grayton M.P.H.
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  5. Thomas V. Williams Ph.D., M.S.
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Correspondence to Mary Jo Larson Ph.D., M.P.A. .

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Editors and Affiliations

  1. Department of Human Development & Family Studies, Military Family Research Institute, Purdue University, West Lafayette, Indiana, USA

    Shelley MacDermid Wadsworth

  2. Dept. Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA

    David S. Riggs

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Larson, M.J., Mohr, B.A., Lorenz, L., Grayton, C., Williams, T.V. (2014). General and Specialist Health Care Utilization in Military Children of Army Service Members Who Are Deployed. In: MacDermid Wadsworth, S., Riggs, D. (eds) Military Deployment and its Consequences for Families. Risk and Resilience in Military and Veteran Families. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8712-8_6

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