Effects of Parental Military Deployment on Pediatric Outpatient and Well-Child Visit Rates

Abstract

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. 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. 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. 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.