دورية أكاديمية
Caring for Service Members Who Have Been Sexually Assaulted: The Military Health System.
| العنوان: | Caring for Service Members Who Have Been Sexually Assaulted: The Military Health System. |
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| المؤلفون: | Murray AL; Department of Medical & Clinical Psychology, Uniformed Services University, Bethesda, MD 20814, USA., Perez Koehlmoos T; Center for Health Services Research, Uniformed Services University, Bethesda, MD 20814, USA., Banaag A; Center for Health Services Research, Uniformed Services University, Bethesda, MD 20814, USA.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA., Schvey NA; Department of Medical & Clinical Psychology, Uniformed Services University, Bethesda, MD 20814, USA. |
| المصدر: | Military medicine [Mil Med] 2023 Jul 22; Vol. 188 (7-8), pp. 1609-1614. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 2984771R Publication Model: Print Cited Medium: Internet ISSN: 1930-613X (Electronic) Linking ISSN: 00264075 NLM ISO Abbreviation: Mil Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2018- : Oxford : Oxford University Press Original Publication: Washington, D.C. : Association of Military Surgeons, United States, 1955- |
| مواضيع طبية MeSH: | Military Personnel*/statistics & numerical data , Military Personnel*/psychology , Sex Offenses*/statistics & numerical data, Humans ; Female ; Adult ; Male ; United States ; Adolescent ; Middle Aged ; Logistic Models ; Prevalence ; Odds Ratio ; Military Health Services/statistics & numerical data ; Patient Acceptance of Health Care/statistics & numerical data |
| مستخلص: | Introduction: Reports of sexual assault (SA) in the U.S. Military have increased in recent years. Given the deleterious effects of military SA, there remains a need for large-scale studies to assess SA-related health care utilization among active duty service members (ADSMs). The present study, therefore, utilized Military Health System (MHS) data to determine the prevalence of SA-related care, sociodemographic characteristics of ADSMs receiving said care, and the type of provider seen during the initial SA-related health encounter. Materials and Methods: Utilizing the MHS Data Repository and Defense Enrollment Eligibility Reporting System, all ADSMs from the Air Force, Army, Navy, and Marine Corps during fiscal years (FY) 2016-2018 were identified. Those with an International Classification of Diseases diagnostic code related to SA during the study period were isolated. Descriptive statistics and multivariable logistic regression analyses were conducted. The study was exempt from human subjects review. Results: A total of 1,728,433 ADSMs during FY 2016-2018 were identified, of whom 4,113 (0.24%) had an SA-related health encounter. Rates of SA-related health care encounters decreased each FY. Women (odds ratio [OR] = 12.02, P < .0001), those in the Army (reference group), and enlisted personnel (OR = 2.65, P < .0001) were most likely to receive SA-related health care, whereas ADSMs aged 18-25 years had lower odds (OR = 0.70, P < .0001). In addition, higher odds of SA-related care were observed among those identifying as American Indian/Alaskan Native (OR = 1.37, P = .02) and "Other" race (e.g., multiracial) (OR = 4.60, P < .0001). Initial SA-related health encounters were most likely to occur with behavioral health providers (41.4%). Conclusions: The current study is the first large-scale examination of health care usage by ADSMs in the MHS who have experienced SA. Results indicated that rates of SA-related care decreased throughout the study period, despite the increasing rates of SA documented by the DoD. Inconsistent with previous research and DoD reports indicating that younger ADSMs are at the highest risk for SA, our study observed lower rates of SA-related care among those aged 18-25 years; additional research is warranted to determine if there are barriers preventing younger ADSMs from seeking SA-related health care. Behavioral health providers were most frequently seen for the initial SA-related encounter, suggesting that they may be in a unique position to provide care and/or relevant referrals to ADSMs who have experienced SA. The present study provides key insights about the prevalence of SA-related care within the MHS, not yet reported in previous literature, which could help inform MHS screening practices. The strengths of the study are the inclusion of the entire active duty population without the need for research recruitment given the utilization of de-identified TRICARE claims data. The study is limited by its use of health care claims data, general SA International Classification of Diseases codes as a proxy indicator for military SA, and lack of data on ethnicity. Future research utilizing MHS data should examine mental health outcomes following the documentation of SA and disruptions in SA-related care due to SARS-CoV-2. (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2022. This work is written by (a) US Government employee(s) and is in the public domain in the US.) |
| معلومات مُعتمدة: | HU0001-11-1-0023 U.S. |
| تواريخ الأحداث: | Date Created: 20220625 Date Completed: 20240619 Latest Revision: 20240619 |
| رمز التحديث: | 20240619 |
| مُعرف محوري في PubMed: | PMC9384439 |
| DOI: | 10.1093/milmed/usac175 |
| PMID: | 35751587 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1930-613X |
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| DOI: | 10.1093/milmed/usac175 |