Quality of Care for Children with Medical Complexity in the Military Health System and Associations with Maternal Behavioral Health

Motivation and Aims:

The overall objectives of this project are to use population-level healthcare claims data to enhance military readiness by expanding our knowledge of childhood medical complexity epidemiology, healthcare quality, and associations with maternal mental/behavioral health in military beneficieries. We will achieve these objectives through the following Specific Aims:

1) Determine the prevalence and timing of onset of childhood medical complexity, from birth to 5 years of age, among children born to Military Health System beneficiaries from 2005-2015.
2) Characterize the composition of the ambulatory healthcare team from children with medical complexity (CMC) and identify the predominant provider and setting of care (military treatment facility providers or TRICARE-authorized providers, i.e., purchased care) from birth to 5 years of age to determine (a) how the predominant provider and setting of care vary by age and across geographic regions, and (b) how the predominant provider and setting of care are associated with healthcare utilization and quality.
3) Determine the prevalence and timing of mental/behavioral health conditions among mothers of CMC, and identify the associations between these conditions and CMC healthcare utilization and quality.

Novel Approach:

• Data derived from a large birth cohort including records from millions of eligible beneficiaries. 
• Ability to identify incident diagnoses as beneficiaries enter the cohort at birth. 

Funding: This work was funded under the opportunity title of Military Health System Research (22-DHA-MHSR) of the Defense Health Agency.
Disclaimer: The views expressed in this research are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government. The study protocol was approved by the Naval Health Research Center Institutional Review Board in compliance with all applicable Federal regulations governing the protection of human subjects.