Geographic Barriers to Behavioral Health Care May Put Remote Service Members at Risk
Mar 31, 2021
The authors evaluated access and quality of care provided to more than 93,000 service members with posttraumatic stress disorder, depression, or substance use disorder who reside remotely from a military treatment facility and compared their care with that received by non-remote service members. The assessment identified strengths in and areas for improvement for the Military Health System.
Access and Quality for Remote Service Members
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Geographic location can be a barrier to accessing and receiving high-quality behavioral health care for both civilians and military personnel. As a consequence, service members who reside far from military treatment facilities may be at higher risk for poorer clinical outcomes than those who are less remotely located.
The authors evaluate remote service members' access to Military Health System (MHS) care for those with posttraumatic stress disorder (PTSD), depression, or substance use disorder (SUD) and assess the quality of the behavioral health care they received. The report highlights how quality-measure performance varies by remote status, focusing on differences in quality of care that are large and potentially clinically significant. The authors also discuss policy implications and offer recommendations for how the military can use new strategies — including synchronous telehealth or technology-enabled interventions — to ensure access to high-quality care for all service members, regardless of location.
Remote Versus Non-Remote Differences in Demographics and Behavioral Health Care Utilization
Access to Direct Care for the Behavioral Health Cohort
Quality of Behavioral Health Care: Initial Care
Quality of Behavioral Health Care: Medication Management
Quality of Behavioral Health Care: Transitions of Care
Summary and Recommendations
Sensitivity Analyses of Remoteness Definition
Technical Specifications for Access and Behavioral Health Quality of Care Measures
PTSD, Depression, and SUD Cohort Demographic and Service Characteristics
Cohort Descriptive Data by Diagnostic Cohort
Summary of Remote Versus Non-Remote Differences in Behavioral Health Quality Measures
This research was sponsored by the Defense Health Agency and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute.
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