title: Impact of the 2009 influenza (H1N1) pandemic on the United States military health care system.
abstract: BACKGROUND
  During public health emergencies, the Military Health System experiences challenges similar to those across the U.S. public and private health systems. This study explored how 1 such event, the 2009/2010 influenza (H1N1) pandemic, impacted health care utilization and associated costs in the Military Health System.
  
  
  METHODS
  Data from the Military Data Repository were used to examine diagnoses, claims data, and dates of services with respect to military or civilian care during 2004-2009/2010 influenza seasons. Comparison analysis was conducted through two-tailed t-tests and regression models.
  
  
  RESULTS
  There was a significant increase in inpatient and outpatient health care utilization during the 2009/2010 H1N1 pandemic year, most markedly for emergency department visits. The 2009/2010 H1N1 pandemic cost the Department of Defense $100 million compared to influenza-related health care costs incurred in previous influenza seasons. Highest health care utilization costs were found in children less than age 5. The greatest cost burden was attributed to immunizations for active duty personnel delivered at military facilities.
  
  
  CONCLUSIONS
  Annual trend analysis of costs and health care utilization would be helpful to plan and resource emerging influenza pandemics and to identify subgroups at greatest risk for contracting influenza.
authors.affiliation: Department of Defense, 7700 Arlington Boulevard, Falls Church, VA 22042-5101, USA.
authors.forename: Diana D
authors.initials: DD
authors.lastname: Jeffery
authors.forename: Martin
authors.initials: M
authors.lastname: Cohen
authors.forename: Arnold
authors.initials: A
authors.lastname: Brooks
authors.forename: Andrea
authors.initials: A
authors.lastname: Linton
authors.forename: Richard
authors.initials: R
authors.lastname: Gromadzki
authors.forename: Christine
authors.initials: C
authors.lastname: Hunter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000191:economics / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D058873:Pandemics / Q000191:economics / Q000706:statistics & numerical data*; D011634:Public Health / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult