General and Specialist Health Care Utilization in Military Children of Army Service Members Who Are Deployed

  • Mary Jo Larson
  • Beth A. Mohr
  • Laura Lorenz
  • Candice Grayton
  • Thomas V. Williams
Part of the Risk and Resilience in Military and Veteran Families book series (RRMV)


This paper on children in Army families is the first to examine objective, non-self-report, measures of all health care utilization inclusive of prescription medications among children experiencing the deployment of a parent. It employs a quasi-experimental, pre–post, non-equivalent group design to compare changes in pediatric health care utilization. Multivariate difference-in-differences regression models isolate the effect of deployment on change in service usage comparing a period prior to deployment to a period starting with the parent’s deployment. The proportion of children using any specialist office visits showed a net increase, while the proportion with any generalist office visits showed a net decline. Post-hoc analysis revealed that these pediatric specialist visits were predominantly, not exclusively, for psychiatric-type services. There also was, in users of antidepressants prescriptions, a 28 % relative increase in children under age 12 and 18 % relative increase in children age 12 years and older. Policy and procedures to support the increased care coordination required of both primary care providers and parents of children who make use of psychiatric specialty services is important, especially since pediatric providers are often in the civilian, and not military, sector.


Health care utilization Psychotropic medication Deployment Military children Difference-in-difference analysis 



This paper is based upon work supported by TRICARE Management Agency through a Program Support Center contract to The CDM Group, Inc. with subcontract to Brandeis University (Contract Number: HHSP23320045009XI, Task Order Number: HHSP233200800001T). We wish to acknowledge the contributions and able guidance of the Task Order Officer, Thomas Williams, PhD, and Ms. Pat Golson of HPA&E, and the invaluable assistance of Ms. Wendy Funk and Ms. Laura Hopkins of Kennell and Associates, and Jennifer MacLeod of Altarum Institute who prepared the project’s data extracts. Finally, the project team benefited from the collaboration of other project staff, including Christopher Tompkins, PhD, Jennifer Perloff, PhD, Grant Ritter, PhD, and Galina Zolotusky at Brandeis University and Michael Keane, PhD and Robert O’Brien at The CDM Group, Inc.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Mary Jo Larson
    • 1
  • Beth A. Mohr
    • 1
  • Laura Lorenz
    • 1
  • Candice Grayton
    • 2
  • Thomas V. Williams
    • 3
  1. 1.Heller School for Social Policy & ManagementBrandeis UniversityWalthamUSA
  2. 2.The CDM Group, Inc.BethesdaUSA
  3. 3.Methods, Measures, and Analyses, Defense Health Cost Assessment and Program EvaluationTRICARE Management ActivityFalls ChurchUSA

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