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The impact of having a child with special healthcare needs on length of military service

APA Citation:

Perkins, E. M., Sorensen, I., Susi, A., & Hisle-Gorman, E. (2021). The impact of having a child with special healthcare needs on length of military service. Military Medicine, usab495. https://doi.org/10.1093/milmed/usab495

Abstract Created by REACH:

This study explored whether having a child with special health care needs (i.e., complex, noncomplex, or no chronic disease) was related to length of service for military parents. Data were analyzed from health care records of 915,584 military families with a child younger than 10 years old. Health care records were used to gather demographic information about the child and family (i.e., child age and sex, military parent sex, marital status, rank) and the military parent’s length of service. Accounting for demographic factors, parents of children with chronic disease had longer military service than parents of children without chronic disease.


Physical health

Branch of Service:

Multiple branches

Military Affiliation:

Active Duty

Subject Affiliation:

Child of a service member or veteran
Military families


Childhood (birth - 12 yrs)
School age (6 - 12 yrs)
Preschool age (2 -5 yrs)


Secondary Analysis


Perkins, Elizabeth M., Sorensen, Ian, Susi, Apryl, Hisle-Gorman, Elizabeth


In 2010, the National Survey of Children with Special Healthcare Needs revealed that parents of children with special healthcare needs (CSHCN) report employment decisions are influenced by healthcare coverage needs. The U.S. military healthcare system arguably offers service member parents of CSHCN with the most comprehensive, inexpensive, long-term healthcare in the country—potentially increasing their incentive to remain in the military. This study explored the effect of having a CSHCN on the length of parental military service.A retrospective cohort was formed using the Military Health System database from 2008 to 2018. Included children were <10 years in 2010 and received ≥1 year of military healthcare between 2008 and 2010. The Pediatric Medical Complexity Algorithm categorized children as having special healthcare needs via ICD 9/10 codes as having complex chronic (C-CD), non-complex chronic (NC-CD), or no chronic disease (CD). Families were classified by the child with the most complex healthcare need. Duration of military healthcare eligibility measured parental length of service (LOS). ANOVA and linear regression analysis compared LOS by category. Logistic regression determined odds of parental LOS lasting the full 8-year study length. Adjusted analyses controlled for child age and sex, and military parent sex, rank, and marital status.Over 1.45 million children in 915,584 families were categorized as per the algorithm. Of individual children included, 292,050 (20.1%) were CSHCN including those with complex chronic and non-complex chronic conditions. After grouping by family, 80,909 (8.8%) families had a child/children with C-CD (mean LOS 6.39 years), 170,787 (18.7%) families had a child/children with NC-CD (mean LOS 6.41 years), and 663,888 (72.5%) families had children with no CD (mean LOS 5.7 years). In adjusted analysis, parents of children with C-CD and NC-CD served 0.4 [0.37-0.42] and 0.33 [0.31-0.34] years longer than parents of children with no CD; odds of parents serving for the full study period were increased 33% (1.33 [1.31-1.36]) in families of children with C-CD and 27% (1.27 [1.26-1.29]) in families of children with NC-CD. Findings indicate that military parents of CSHCN serve longer military careers than parents of children with no chronic conditions. Continued provision of free, high-quality healthcare coverage for dependent children may be important for service member retention. Retaining trained and experienced service members is key to ensuring a ready and lethal U.S. military.

Publisher/Sponsoring Organization:

Oxford Academic

Publication Type:

REACH Publication
Featured Research

Author Affiliation:

Department of Pediatrics, Walter Reed National Military Medical Center, EMP
Department of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University, IS
Department of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University, AS
Department of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University, EHG


healthcare, military youth, dependents

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Research Summary

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