Symposia
Military and Veterans Psychology
Amanda Murray, M.A., M.S.
Doctoral Candidate
Uniformed Services University of the Health Sciences
Alexandria, Virginia
Tracey Koehlmoos, PhD
Professor/Director
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Amanda Banaag, MPH
Data Analyst
Center for Health Services Research; Henry M. Jackson Foundation for the Advancement of Military Medicine
Bethesda, Maryland
Background: Reports of sexual assault (SA) in the military have increased in recent years. Elucidating the rate of SA-related healthcare encounters among service members (SMs) and possible demographic differences is critical for the Department of Defense to provide adequate care.
Method: Utilizing the Military Health System Data Repository and Defense Enrollment Eligibility Reporting System, all SMs from the Air Force, Army, Navy, and Marine Corps during fiscal years 2016-2018 were identified. Subsequently, SMs with an ICD-10 diagnostic code indicating SA on a healthcare encounter at either a military (direct care) or civilian (private sector care) facility were isolated. Multivariable logistic regressions and Chi-square tests of independence were performed to examine demographics and utilization patterns of care type.
Results: A total of 1,728,433 SMs were identified, of whom 4,113 (0.24%) had an SA-related health encounter. Women were 12 times more likely than men (OR = 12.02, p < .0001) to have had an SA-related health encounter; however, men were more likely to have utilized direct care (versus purchased) (X2= 6.63, p < .01). In addition, American Indian/Alaskan Native (OR = 1.37, p = .02) and multiracial (OR = 4.60, p < .0001) SMs had greater odds of receiving SA-related care compared to White SMs and likewise had greater utilization of direct vs. private sector care than SMs of other races (X2 = 9.90, p = .04).
Discussion: This study is among the first to assess SA-related healthcare encounters across multiple branches of the military. Consistent with previous research, female SMs were more likely to receive SA-related care than males. Men had greater odds of seeking SA-related care through military treatment facilities (direct care) than women, whereas women had slightly greater odds of seeking care by providers outside of the military setting (private sector care). In addition, American Indian/Alaskan Native and multiracial SMs had the highest odds of receiving SA-related care and were more likely to seek direct care. However, it is possible there were other SMs who sought purchased care without the use of the military insurance and therefore were not captured in the data. Future research should explore factors that may contribute to demographic differences in type of care received and health outcomes over time. Given that a proportion of SMs elect to use purchased care, findings from the present study may be valuable for both military and civilian providers to ensure allocation of resources and culturally responsive SA-related care.