Understanding Behavioral Healthcare Services in the Army and the Correlation between Months Deployed and Utilization.

摘要

The purpose of this quantitative study was to use the determinants of health care posited by Andersen's behavioral model to better understand mental health care services utilization in the Army. A random sample of 3,500 soldiers was used for analysis in this study. Regression analyses were conducted to assess the significance of the effect of the independent variables (socioeconomic, military, and clinical) on the number of visits to both the primary care and behavioral health clinics. The results highlighted that age and gender components of predisposing factors had a significant effect on the number of visits to both areas F(10, 3489) = 40.75, p = < .001. Soldiers over 40 years and those younger than 20 years reported a significantly higher number of visits to primary care clinics. Also females visited both primary care and behavioral health clinics significantly more often than their male counterparts. The multivariate test performed using Wilk's lamda and the F test showed a significant effect of deployment on visits to both clinic settings F(2, 37) = 15.56; p < .0005. The predictor variable deployment showed a significant effect on number of visits to primary care clinic. Soldiers deployed 1-15 months reported 0.162 visits to behavioral health clinics on an average more than those who were never deployed. This difference was found to be statistically significant t(3347) = 3.277, p = < .001. Notably, those who never deployed made a significantly higher number of visits to primary care clinics than those who were deployed. Analysis of the data clearly indicates that deployment is a significant factor influencing visits to either clinic setting. The study findings demonstrate that mental health utilization occurs in both settings and there is no significant correlation between where care is accessed. It also shows that, although utilization significantly differ across deployments, and no deployments, the difference in the number of visits to primary care clinics and behavioral health clinics increased with increases in the length of deployment. Future studies concerning deployments and the utilization of behavioral health services in other military branches in either settings may be beneficial to healthcare providers.