TY - JOUR
T1 - TRICARE Extended Care Health Option Program
T2 - Prevalence of pediatric ECHO enrollees and healthcare service utilization in the Military Health System
AU - Hsu, Nicole M.
AU - Morris, Kyla
AU - Banaag, Amanda
AU - Koehlmoos, Tracey P.
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/7
Y1 - 2023/7
N2 - Background: The Extended Care Health Option (ECHO) Program is a TRICARE program aimed at reducing the disabling effects of chronic medical conditions for beneficiaries of the Department of Defense (DoD) healthcare program. However, little is known about military-connected children enrolled in the program. Objective/Hypothesis: The aim of this study was to examine the demographic makeup of pediatric ECHO beneficiaries and their healthcare claims data. This is the first study to evaluate healthcare utilization of this subset of military dependents. Methods: A cross-sectional study was performed evaluating ECHO enrolled pediatric beneficiaries and their health service utilization during 2017–2019. TRICARE claims and military treatment facility (MTF) encounter data were utilized to evaluate health service utilization and identify the most frequently reported ICD-10-CM and CPT codes associated with care for this population. Results: Of the 2,001,619 dependents aged 0–26 years who received medical care in the Military Health System (MHS) during 2017–2019, 21,588 individuals (1.1%) were enrolled in ECHO. The majority of encounters (65.4%) were provided in the MTFs. Inpatient visits, therapeutic services, and in-home nursing care were the top utilized private sector care services. Outpatient visits encompassed 94.8% of healthcare encounters, and neurodevelopmental disorders were the top principal diagnoses among ECHO beneficiaries. Conclusions: With the increasing prevalence of children with medical complexity and developmental delay, the pediatric TRICARE beneficiaries eligible for ECHO will likely continue to rise. Improving services and supports for military children with special healthcare needs is needed to maximize their developmental trajectory.
AB - Background: The Extended Care Health Option (ECHO) Program is a TRICARE program aimed at reducing the disabling effects of chronic medical conditions for beneficiaries of the Department of Defense (DoD) healthcare program. However, little is known about military-connected children enrolled in the program. Objective/Hypothesis: The aim of this study was to examine the demographic makeup of pediatric ECHO beneficiaries and their healthcare claims data. This is the first study to evaluate healthcare utilization of this subset of military dependents. Methods: A cross-sectional study was performed evaluating ECHO enrolled pediatric beneficiaries and their health service utilization during 2017–2019. TRICARE claims and military treatment facility (MTF) encounter data were utilized to evaluate health service utilization and identify the most frequently reported ICD-10-CM and CPT codes associated with care for this population. Results: Of the 2,001,619 dependents aged 0–26 years who received medical care in the Military Health System (MHS) during 2017–2019, 21,588 individuals (1.1%) were enrolled in ECHO. The majority of encounters (65.4%) were provided in the MTFs. Inpatient visits, therapeutic services, and in-home nursing care were the top utilized private sector care services. Outpatient visits encompassed 94.8% of healthcare encounters, and neurodevelopmental disorders were the top principal diagnoses among ECHO beneficiaries. Conclusions: With the increasing prevalence of children with medical complexity and developmental delay, the pediatric TRICARE beneficiaries eligible for ECHO will likely continue to rise. Improving services and supports for military children with special healthcare needs is needed to maximize their developmental trajectory.
KW - Healthcare utilization
KW - Medically complex children
KW - Military families
KW - Military medicine
KW - Pediatrics
UR - http://www.scopus.com/inward/record.url?scp=85150279704&partnerID=8YFLogxK
U2 - 10.1016/j.dhjo.2023.101451
DO - 10.1016/j.dhjo.2023.101451
M3 - Article
C2 - 36941191
AN - SCOPUS:85150279704
SN - 1936-6574
VL - 16
JO - Disability and Health Journal
JF - Disability and Health Journal
IS - 3
M1 - 101451
ER -