Access to health care and medical health services use for Canadian military families posted to Ontario: a retrospective cohort study

Abstract

Introduction: Canadian military spouses have reported issues accessing and maintaining high quality health care. There is no Canadian research quantifying the scope of the problem. Methods: This is a retrospective cohort study using administrative data. We included military spouses and dependents relocated to Ontario between January 8, 2008 and March 31, 2013, along with a matched civilian reference group. We measured hospitalizations, emergency department (ED) visits, and physician visits. Comparisons of first health care contact, medical health services use, and time to first health services use controlled for age, sex, and geography. Results: The cohort included 7,508 military family members and 30,032 matched civilians. Point of first health care system contact differed between military family members and the civilian reference group ( p < 0.001). Military family members had a longer time to their first health care contact than the civilian reference group (median 118 days vs. 84 days, p < 0.001). Similarities and differences between military family and civilian health services use existed. For example, military children and youth were less likely to see a paediatrician than the civilian reference group (17.7% vs. 26.0%, p < 0.001), and less likely to receive non-influenza vaccinations (23.2% vs. 32.3%, p < 0.001). Discussion: This study provides evidence supporting the hypothesis that military families have different access to, and use of, provincial health services than the general Ontario population and suggests support during relocations is needed. It is important to further understand how these patterns impact health outcomes and continuity of care and to contextualize these findings with potential differences in the underlying need for health services.