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Association of military deployment of a parent or spouse and changes in dependent use of health care services.
Med Care. 2012 Sep; 50(9):821-8.MC

Abstract

BACKGROUND

U.S. Armed Forces members and spouses report increased stress associated with combat deployment. It is unknown, however, whether these deployment stressors lead to increased dependent medication use and health care utilization.

OBJECTIVE

To determine whether the deployment of Army active duty members (sponsors) is associated with changes in dependent health care utilization.

DESIGN

A quasi-experimental, pre-post study of health care patterns of more than 55,000 nonpregnant spouses and 137,000 children of deployed sponsors and a comparison group of dependents.

MEASURES

Changes in dependent total utilization in the military health system, and separately in military-provided and purchased care services in the year following the sponsors' deployment month for office visit services (generalist, specialist); emergency department visits; institutional stays; psychotropic medication (any, antidepressant, antianxiety, antistimulant classes).

RESULTS

Sponsor deployment was associated with net increased use of specialist office visits (relative percent change 4.2% spouses; 8.8% children), antidepressants (6.7% spouses; 17.2% children), and antianxiety medications (14.2% spouses; 10.0% children; P<0.01) adjusting for group differences. Deployment was consistently associated with increased use of purchased care services, partially, or fully offset by decreased use of military treatment facilities.

CONCLUSIONS

These results suggest that emotional or behavioral issues are contributing to increased specialist visits and reliance on medications during sponsors' deployments. A shift to receipt of services from civilian settings raises questions about coordination of care when families temporarily relocate, family preferences, and military provider capacity during deployment phases. Findings have important implications for the military health system and community providers who serve military families, especially those with children.

Authors+Show Affiliations

Schneider Institute of Health Policy, The Heller School, Brandeis University, Waltham, MA 02454-9110, USA. larson@brandeis.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

22573256

Citation

Larson, Mary Jo, et al. "Association of Military Deployment of a Parent or Spouse and Changes in Dependent Use of Health Care Services." Medical Care, vol. 50, no. 9, 2012, pp. 821-8.
Larson MJ, Mohr BA, Adams RS, et al. Association of military deployment of a parent or spouse and changes in dependent use of health care services. Med Care. 2012;50(9):821-8.
Larson, M. J., Mohr, B. A., Adams, R. S., Ritter, G., Perloff, J., Williams, T. V., Jeffery, D. D., & Tompkins, C. (2012). Association of military deployment of a parent or spouse and changes in dependent use of health care services. Medical Care, 50(9), 821-8. https://doi.org/10.1097/MLR.0b013e31825516d8
Larson MJ, et al. Association of Military Deployment of a Parent or Spouse and Changes in Dependent Use of Health Care Services. Med Care. 2012;50(9):821-8. PubMed PMID: 22573256.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of military deployment of a parent or spouse and changes in dependent use of health care services. AU - Larson,Mary Jo, AU - Mohr,Beth A, AU - Adams,Rachel Sayko, AU - Ritter,Grant, AU - Perloff,Jennifer, AU - Williams,Thomas V, AU - Jeffery,Diana D, AU - Tompkins,Christopher, PY - 2012/5/11/entrez PY - 2012/5/11/pubmed PY - 2012/10/31/medline SP - 821 EP - 8 JF - Medical care JO - Med Care VL - 50 IS - 9 N2 - BACKGROUND: U.S. Armed Forces members and spouses report increased stress associated with combat deployment. It is unknown, however, whether these deployment stressors lead to increased dependent medication use and health care utilization. OBJECTIVE: To determine whether the deployment of Army active duty members (sponsors) is associated with changes in dependent health care utilization. DESIGN: A quasi-experimental, pre-post study of health care patterns of more than 55,000 nonpregnant spouses and 137,000 children of deployed sponsors and a comparison group of dependents. MEASURES: Changes in dependent total utilization in the military health system, and separately in military-provided and purchased care services in the year following the sponsors' deployment month for office visit services (generalist, specialist); emergency department visits; institutional stays; psychotropic medication (any, antidepressant, antianxiety, antistimulant classes). RESULTS: Sponsor deployment was associated with net increased use of specialist office visits (relative percent change 4.2% spouses; 8.8% children), antidepressants (6.7% spouses; 17.2% children), and antianxiety medications (14.2% spouses; 10.0% children; P<0.01) adjusting for group differences. Deployment was consistently associated with increased use of purchased care services, partially, or fully offset by decreased use of military treatment facilities. CONCLUSIONS: These results suggest that emotional or behavioral issues are contributing to increased specialist visits and reliance on medications during sponsors' deployments. A shift to receipt of services from civilian settings raises questions about coordination of care when families temporarily relocate, family preferences, and military provider capacity during deployment phases. Findings have important implications for the military health system and community providers who serve military families, especially those with children. SN - 1537-1948 UR - https://wwww.unboundmedicine.com/medline/citation/22573256/Association_of_military_deployment_of_a_parent_or_spouse_and_changes_in_dependent_use_of_health_care_services_ L2 - https://doi.org/10.1097/MLR.0b013e31825516d8 DB - PRIME DP - Unbound Medicine ER -