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Health care utilization among children with chronic conditions in military families
Marji Erickson Warfield1, Rachel Sayko Adams2, Grant A Ritter2
1Starr Center on Intellectual and Developmental Disabilities, Heller School for Social Policy and Management, Brandeis University, MS 035, 415 South Street, Waltham, MA, 02453-2728, USA.
Insights
This study analyzed healthcare use in military children with chronic conditions, finding higher utilization for those with behavioral and physical health issues. Findings inform service planning for vulnerable military families.
Area of Science:
- Pediatric Health Services Research
- Military Health Systems
- Chronic Condition Management
Background:
- Limited research exists on healthcare utilization among child dependents of military personnel with chronic conditions.
- Previous studies focused on civilian children, leaving a gap in understanding military-dependent healthcare needs.
Purpose of the Study:
- To identify children with chronic conditions within the military population.
- To examine their healthcare utilization patterns.
- To analyze the association between condition type and healthcare use.
Main Methods:
- Sample derived from child dependents (0-18 years) of military personnel enrolled in healthcare in FY2011.
- Chronic conditions defined by diagnoses and repeated specialty care visits (≥2).
- One-year healthcare utilization data collected, including inpatient stays, outpatient visits, ED visits, and prescriptions.
Main Results:
- ADHD/conduct disorders (41.2%), behavioral health (30.4%), asthma (25.3%), and arthritis (23.8%) were most prevalent.
- Higher utilization observed for children with co-occurring behavioral and physical health conditions, younger children, and those in the Extended Health Care Options (ECHO) program.
- 12% had inpatient stays, 63% used the ED (mean 4.6 visits), and mean outpatient visits were 27.9.
Conclusions:
- Prevalence and utilization data can guide future healthcare service planning for military children.
- Specific subgroups, like those with combined behavioral and physical health conditions, require targeted support.
- Findings highlight the need for enhanced access to military support programs for children with chronic conditions.
Background:
Studies have examined utilization of health care services by civilian children with chronic conditions but not utilization among child dependents of military personnel.
Objective:
To identify children with chronic conditions among military members and retirees and examine their health care utilization and its association with type of condition.
Methods:
We derived our sample from child dependents ages birth to 18 years of military personnel with health care enrollment in FY2011. We defined chronic conditions based on diagnoses and repeated specialty care visits. We accrued one year of health care utilization for each child starting with the date of first diagnosis that qualified (i.e., 2 + visits). Health care utilization measures were any inpatient stay; number of outpatient visits (excluding emergency department [ED] visits), ED visits, and number of psychotropic and non-psychotropic prescriptions.
Results:
Conditions with the highest prevalence were ADHD/conduct disorders (41.2%), other behavioral health (BH) disorders (30.4%), asthma (25.3%) and arthritis (23.8%). Boys and children ages 6-18 were more likely to have BH conditions. Twelve percent had inpatient stays, 63% used the ED, and mean ED visits was 4.6. The mean outpatient visits was 27.9. Utilization was consistently higher for children with both BH and physical health (PH) conditions, children under age 5 (except for number of psychotropic prescriptions), and those enrolled in the military's Extended Health Care Options (ECHO) program.
Conclusions:
Prevalence and utilization findings provide data for future service planning and highlight subgroups of children with chronic conditions who may need better access to supportive military programs.
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