Roopa Seshadri is a senior research scientist at PolicyLab at Children's Hospital of Philadelphia (CHOP), in Pennsylvania.
Douglas Strane is a research project manager at PolicyLab at CHOP.
Health Aff (Millwood). 2019 Aug;38(8):1377-1385. doi: 10.1377/hlthaff.2019.00274.
Children in military families, who receive health insurance through the TRICARE program, face barriers to care such as frequent relocations, unique behavioral health needs, increased complex health care needs, and lack of accessible specialty care. How TRICARE-insured families perceive health care access and quality for their children compared to their civilian peers' perceptions remains unknown. Using data from the Medical Expenditure Panel Survey, we found that TRICARE-insured families were less likely to report accessible or responsive care compared to civilian peers, whether commercially or publicly insured or uninsured. Military families whose children had complex health or behavioral health care needs reported worse health care access and quality than similar nonmilitary families. Addressing these gaps may require military leaders to examine barriers to achieving acceptable health care access across military treatment facilities and off-base nonmilitary specialty providers, particularly for children with complex health or behavioral health needs.
接受 TRICARE 计划医疗保险的军人家庭的儿童在获得医疗服务方面面临诸多障碍，例如频繁搬迁、独特的行为健康需求、更多的复杂医疗需求以及缺乏可及的专科医疗服务。TRICARE 保险家庭对儿童获得医疗服务的便利性和质量的看法与平民同龄人相比如何，目前尚不清楚。利用来自医疗支出调查的数据，我们发现，与平民同龄人相比，无论其是否通过商业保险、公共保险或无保险获得医疗保险，TRICARE 保险家庭报告的可及性或响应性护理的可能性更小。有复杂健康或行为健康护理需求的军人家庭报告称，其获得医疗服务的便利性和质量比类似的非军人家庭更差。解决这些差距可能需要军队领导人检查在军队治疗设施和非军队专科医疗机构提供可接受的医疗服务方面的障碍，特别是对于有复杂健康或行为健康需求的儿童。
