Publication year
2010
Citation Title
Effects of parental military deployment on pediatric outpatient and well-child visit rates.
Journal Name
Pediatrics
Journal Volume
126
Issue Number
1
Page Numbers
22-27
DOI
10.1542/peds.2009-2704
Summary
Medical claims data were utilized to determine the ratios of outpatient and well-child visit rates during parental deployment, compared with those during non-deployment. Deployment influenced the rate of health care visits differently for single and married parents. These differences should be explored further to determine the best approach to meeting military children's medical needs during a parental deployment.
Key Findings
Overall, increases of 7% for outpatient visits and 8% for well-child visits were seen during periods of parental deployment compared with periods of non-deployment.
Children of single military parents had decreased rates of both outpatient visits and well-child visits during periods of deployment.
Children of married military parents had increased rates of both outpatient visits and well-child visits during periods of deployment. This effect was strongest among younger married parents compared to older married parents.
Implications for Program Leaders
Provide support to at-home caregivers across a range of modalities such as peer support, educational classes, and social networking support
Provide specific outreach to target populations, such as military families with young, single parents, and distribute information regarding medical health care services during deployment
Educate civilian providers who treat children of military Service members about the unique needs of military families related to deployment
Implications for Policy Makers
Consider developing programs to support at-home parents and caregivers, especially those caring for children of single military parents, during deployment
Continue to support services that help military families cope with deployment, including services for medical needs
Encourage single military parents to discuss with the family member or caregiver responsible for their child during deployment about the medical services available to their children
Methods
Participants were identified using the Defense Eligibility and Enrollment System.
This study focused on children of deployed Service members who were under the age of two years.
Medical claim data from fiscal year 2007 were examined.
Participants
There were 54,395 children with deployed parents in this study.
Most children were male (51%), White (64%), and had a mean age of 0.54 years (SD = 0.50).
Forty-one percent were Army, 23% Air Force, 22% Navy, and 11% Marine Corps; 74% were junior enlisted personnel (grades E1–E6).
Limitations
This study focused on Active Duty Service members; therefore, findings may not generalize to Service members in other components of the military (i.e., Reserve or National Guard).
Medical visits obtained from non-military healthcare providers were not captured for this analysis; therefore, decreased rates among the children of single deployed parents only reflect decreases within their entitled health insurance plan, not in general.
Data were classified as deployed or non-deployed based on the sponsor parents' deployment status; families with two military parents may have been classified incorrectly if the non-sponsor parent was deployed during the study period.
Avenues for Future Research
Explore factors that contribute to increases in medical visits during deployment (e.g., increased parental and/or child psychological stress)
Examine why deployment may have different effects on single versus married parents (e.g., non-parent caregivers, child relocation, use of health care services outside the military system, and increased symptoms of stress)
Investigate why deployment may have different effects on younger versus older married parents (e.g., social networks, financial resources, parenting experience)
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: The objective of this study was to determine whether parental deployment affected the rates at which children of military parents accessed health care within the military health system. Methods: We linked outpatient health care claims data for military service members' children <2 years of age from fiscal year 2007 to the parental deployment history during the same period. Incidence rate ratios (IRRs) for all visits and well-child visits were determined according to parental deployment status. Results: A total of 169,986 children were identified, with 1,772,703 outpatient visits. Of those children, 32% had a parent deployed during the study period. Well-child visits constituted 27% of all outpatient visits. The unadjusted visit rates for all visits and well-child visits were 10.4 and 2.8 visits per year, respectively. Children of single parents had decreased rates of outpatient visits (IRR: 0.84 [95% confidence interval [CI]: 0.80–0.89]; P< .001) and well-child visits (IRR: 0.88 [95% CI: 0.84–0.93]; P< .001) during deployment. Children of married parents, however, had increased rates of both outpatient visits (IRR: 1.08 [95% CI: 1.03–1.09]; P< .001) and well-child visits (IRR: 1.08 [95% CI: 1.07–1.09]; P< .001) during deployment. There was interaction between parental marital status and deployment, which was most significant among parents <24 years of age and consistently decreased with increasing parental age. Conclusion: Children of young, single, military parents are seen less frequently for acute and well-child care when their parent is deployed, whereas children of married parents are seen more frequently in the military health system.
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