Health care utilization among children with chronic conditions in military families

Marji Erickson Warfield; Rachel Sayko Adams; Grant A Ritter; Anne Valentine; Thomas V Williams; Mary Jo Larson

doi:10.1016/j.dhjo.2018.06.002

Health care utilization among children with chronic conditions in military families

Disabil Health J. 2018 Oct;11(4):624-631. doi: 10.1016/j.dhjo.2018.06.002. Epub 2018 Jun 30.

Authors

Marji Erickson Warfield¹, Rachel Sayko Adams², Grant A Ritter³, Anne Valentine⁴, Thomas V Williams⁵, Mary Jo Larson⁶

Affiliations

¹ Starr 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. Electronic address: mew@brandeis.edu.
² Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, MS 035, 415 South Street, Waltham, MA, 02453-2728, USA. Electronic address: radams@brandeis.edu.
³ Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, MS 035, 415 South Street, Waltham, MA, 02453-2728, USA. Electronic address: ritter@brandeis.edu.
⁴ Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, MS 035, 415 South Street, Waltham, MA, 02453-2728, USA. Electronic address: anvalent@brandeis.edu.
⁵ NORC at the University of Chicago, 1155 East 60th Street 3rd Floor, Chicago, IL, 60637, USA. Electronic address: Williams-Thomas@norc.org.
⁶ Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, MS 035, 415 South Street, Waltham, MA, 02453-2728, USA. Electronic address: larson@brandeis.edu.

Abstract

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.

Keywords: Children with chronic conditions; Developmental/behavioral issues; Health care utilization; Military families.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Child
Child, Preschool
Chronic Disease / therapy*
Disabled Persons / statistics & numerical data*
Emergency Service, Hospital / statistics & numerical data*
Female
Humans
Infant
Infant, Newborn
Male
Military Family / statistics & numerical data*
Patient Acceptance of Health Care / statistics & numerical data*
United States

Grants and funding

R21 HD076340/HD/NICHD NIH HHS/United States