Health care utilization among children with chronic conditions in military families.

Chronic conditions were identified from claims, not from clinical assessment, so the study does not show what daily activities were limited or how severe each child's condition was. The condition list came from a national survey definition, and other chronic condition lists could have selected a different group of children. The study did not capture services outside the military health care system, such as school-based services. It covers only one fiscal year during an elevated deployment period, so the pattern may not represent typical use. The analysis is observational, so associations with ECHO participation, branch, rank, or multiple conditions cannot show that any program caused higher or lower use. Most care was purchased from civilian providers, but the paper does not report how care was coordinated between military and civilian providers.

The article's conflict statement says Thomas V. Williams, Ph.D., was employed by the Department of Defense's Defense Health Agency during the conduct of this study. The supplied publication types also list NIH extramural support.

Do not read the higher use among ECHO participants as evidence that ECHO caused more visits or that military care failed. The study is an observational claims analysis, and it did not measure daily function or whether services met needs.