Despite a universal healthcare system in Canada, military families have different access to and use of provincial healthcare services following relocations compared to the general population, according to a new study by researchers at the Institute for Clinical Evaluative Sciences (ICES).
“This is the first Canadian study to examine healthcare services use for the spouses and dependents of active Canadian Armed Forces members. Canadian military families relocate three to four times more often than civilians, within and across provinces, which requires them to re-establish healthcare provision, even in the midst of treatment or while waiting for a referral. Their experience differs from that of their serving military family member, who receives continuous healthcare within a highly specialized and coordinated federal, defence healthcare system,” says Dr. Alyson Mahar, who led this study while an ICES post-doctoral trainee and is currently an assistant professor at the University of Manitoba and research scientist with the Manitoba Centre for Health Policy.
In Canada, more than 57,000 families of Canadian Armed Forces members are eligible to receive healthcare in the provincial and territorial healthcare systems from civilian healthcare providers; 40 per cent of these families live in Ontario. The researchers studied the health records for 7,508 spouses and dependents of active Canadian Armed Forces members and recently deployed Reservists who applied for OHIP coverage from 2008 to 2013. The researchers looked at how the family members entered into the Ontario healthcare system and used services and compared their experiences to 30,032 civilians.
The researchers found that more military family members (18 per cent) had their first contact with the Ontario healthcare system in an emergency department instead of with a family doctor as compared to civilians (14.7 per cent). Military families also had a longer wait to first contact with the health system compared to civilians (118 vs 83 days). Waits to see a specialist were also significantly longer for military families (327 vs 247 days), a difference of almost three months.
“Another striking difference was the potential impact of relocation on health services use for military children and youth,” adds Mahar. “Children and youth in military families were much less likely to see a paediatrician or paediatric specialist than civilian children and youth. Understanding why these differences in health services use occur and intervening where continuity of healthcare is disrupted or there is a potential for harm is necessary to support the wellbeing of Canadian military families.”
The researchers add that their findings support the Military Ombudsman’s call to action for more objective, quantitative research on the health of military families in Canada and underscore the concerns voiced previously by military families across the country concerning their healthcare needs and the needs of their children.
“Access to healthcare is constantly the number one concern expressed by families at the Trenton Military Family Resource Centre. Family healthcare is one of the military family stressors that could be impacted in a positive way when all stakeholders work together. Informed by research like this, a solution is possible,” says Tamara Kleinschmidt, the executive director of the Trenton Military Family Resource Centre.
“Access to healthcare and medical health services use for Canadian military families posted to Ontario: a retrospective cohort study,” was published today in the journal Journal of Military, Veteran and Family Health Research.
Author block: Mahar AL, Aiken AB, Cramm H, Whitehead M, Groome P, Kurdyak P.
The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario
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