Effects of parental military deployment on pediatric outpatient and well-child visit rates

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.

Conclusions: 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.