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Research Questions

  1. How does the deployment cycle affect capacity and beneficiary utilization at Army military treatment facilities (MTFs)?
  2. How does the deployment cycle affect family health care utilization?

The Army was concerned about how the Army Force Generation (ARFORGEN) cycle, established to provide a predictable process by which Army units deploy, reset, and train to become ready and available to deploy again, affected the lives of Army soldiers and their families. In particular, the Vice Chief of Staff of the Army asked RAND Arroyo Center to determine whether ARFORGEN resulted in ebbs and flows in the ability of Army military treatment facilities (MTFs) to provide medical care and respond to changes in family needs as soldiers and care providers deploy and return home. This concern is especially well-founded because military health research has shown that family members of service members utilize health care differently during deployment than when the soldier is at home. This study found that MTF capacity is not greatly affected when soldiers and care providers deploy, and that MTFs may be slightly less busy than when soldiers and care providers are both at home. In aggregate, family member access to health care does not appear to be impinged when soldiers deploy, and soldiers who did not deploy with their unit slightly increase their utilization of health care during those times.

Key Findings

Effects of the deployment cycle on capacity and beneficiary utilization

  • Soldier health care utilization decreases in aggregate with deployments, but nondeploying soldiers utilize more health care while their units are deployed.
  • MTF capacity is not greatly affected when soldiers and care providers deploy. In aggregate, family member access does not appear to be impinged when soldiers deploy, and MTFs may be slightly less busy.
  • The deployment cycle affects installations differentially. The portion of soldiers that deploy from an installation and the portion of providers that deploy from the MTF are two factors that vary across installations and can affect changes in the demand for care and availability of appointments at the MTF.

Effects of the deployment cycle on family health care utilization

  • Spouses and children of single parents were less likely to utilize MTF care when soldiers deployed and were noticeably more likely to utilize care outside their area.
  • All categories of family members shifted their care from MTFs to civilian providers during deployment.
  • Spouses and children utilized more mental health care for stress- and depression-related diagnoses when soldiers in the family deployed. Spouses also increased utilization of antidepressants.
  • Decreases in MTF utilization and increases in civilian care outside the catchment area were greater for younger Army families.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Analysis of Deployment Cycle Effects on MTF Staffing and Aggregate Workloads

  • Chapter Three

    How Does Family Health Care Utilization Change in Response to the Deployment Cycle?

  • Chapter Four

    Conclusions

Research conducted by

The research described in this report was sponsored by the United States Army and conducted by the RAND Arroyo Center.

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