title: Association of military deployment of a parent or spouse and changes in dependent use of health care services.
abstract: BACKGROUND
  U.S. Armed Forces members and spouses report increased stress associated with combat deployment. It is unknown, however, whether these deployment stressors lead to increased dependent medication use and health care utilization.
  
  
  OBJECTIVE
  To determine whether the deployment of Army active duty members (sponsors) is associated with changes in dependent health care utilization.
  
  
  METHODS
  A quasi-experimental, pre-post study of health care patterns of more than 55,000 nonpregnant spouses and 137,000 children of deployed sponsors and a comparison group of dependents.
  
  
  METHODS
  Changes in dependent total utilization in the military health system, and separately in military-provided and purchased care services in the year following the sponsors' deployment month for office visit services (generalist, specialist); emergency department visits; institutional stays; psychotropic medication (any, antidepressant, antianxiety, antistimulant classes).
  
  
  RESULTS
  Sponsor deployment was associated with net increased use of specialist office visits (relative percent change 4.2% spouses; 8.8% children), antidepressants (6.7% spouses; 17.2% children), and antianxiety medications (14.2% spouses; 10.0% children; P<0.01) adjusting for group differences. Deployment was consistently associated with increased use of purchased care services, partially, or fully offset by decreased use of military treatment facilities.
  
  
  CONCLUSIONS
  These results suggest that emotional or behavioral issues are contributing to increased specialist visits and reliance on medications during sponsors' deployments. A shift to receipt of services from civilian settings raises questions about coordination of care when families temporarily relocate, family preferences, and military provider capacity during deployment phases. Findings have important implications for the military health system and community providers who serve military families, especially those with children.
authors.affiliation: Schneider Institute of Health Policy, The Heller School, Brandeis University, Waltham, MA 02454-9110, USA. larson@brandeis.edu
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Larson
authors.forename: Beth A
authors.initials: BA
authors.lastname: Mohr
authors.forename: Rachel Sayko
authors.initials: RS
authors.lastname: Adams
authors.forename: Grant
authors.initials: G
authors.lastname: Ritter
authors.forename: Jennifer
authors.initials: J
authors.lastname: Perloff
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Williams
authors.forename: Diana D
authors.initials: DD
authors.lastname: Jeffery
authors.forename: Christopher
authors.initials: C
authors.lastname: Tompkins
mesh_terms: D000328:Adult; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D000928:Antidepressive Agents / Q000008:administration & dosage; D004363:Drug Utilization; D005190:Family; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents