Clinical outcomes in cystic fibrosis at 6 years of age with tricare insurance coverage

Published:February 12, 2022DOI:


      • Health insurance coverage is associated with outcomes in cystic fibrosis (CF).
      • The role of Tricare, a program for U.S. military members/dependents, is unknown.
      • Within the CFF registry tricare subjects had greater geographic mobility by 6yo.
      • Outcomes for those with tricare appeared more similar to private insurance.
      • Future research should consider treating tricare similar to private insurance.


      Health insurance coverage is associated with outcomes in cystic fibrosis (CF). A fraction of individuals in the United States are covered through Tricare, a federally funded program for military members and their dependents. The role of Tricare on CF health outcomes is unknown. Using a retrospective CF Foundation Patient Registry cohort born 2000–2011, insurance status was defined as any Tricare (n = 328) with reference groups of always private (n = 3,455) and exclusively public (n = 2,669) during the first 6 years of life. Subjects with Tricare coverage attended more CF care centers and lived in more zip codes by age 6 than their counterparts. BMI did not differ between groups. Subjects with Tricare had a higher FEV1 at age 6 compared to those with always public insurance. Overall, outcomes for those with Tricare insurance appeared more similar to those with always private insurance. Future research should consider treating Tricare coverage similar to private insurance.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Cystic Fibrosis
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Kerem E.
        • Corey M.
        • Kerem B.S.
        • Rommens J.
        • Markiewicz D.
        • Levison H.
        • Tsui L.C.
        • Durie P.
        The relation between genotype and phenotype in cystic fibrosis–analysis of the most common mutation (delta F508).
        N Engl J Med. 1990; 323: 1517-1522
        • Collaco J.M.
        • Blackman S.M.
        • McGready J.
        • Naughton K.M.
        • Cutting G.R.
        Quantification of the relative contribution of environmental and genetic factors to variation in cystic fibrosis lung function.
        J Pediatr. 2010; 157 (802-807 e801-803)
        • Schechter M.S.
        • McColley S.A.
        • Silva S.
        • Haselkorn T.
        • Konstan M.W.
        • Wagener J.S.
        Association of socioeconomic status with the use of chronic therapies and healthcare utilization in children with cystic fibrosis.
        J Pediatr. 2009; 155: 634-639
        • Oates G.R.
        • Schechter M.S.
        Social inequities and cystic fibrosis outcomes: we can do better. 18. Ann Am Thorac Soc, 2021: 215-217
        • Tumin D.
        • Crowley E.M.
        • Li S.S.
        • Wooten W.
        • Ren C.L.
        • Hayes Jr, D.
        Patterns of health insurance coverage and lung disease progression in adolescents and young adults with cystic fibrosis.
        Ann Am Thorac Soc, 2020
        • Dickinson K.M.
        • Psoter K.J.
        • Riekert K.A.
        • Collaco J.M.
        Association between insurance variability and early lung function in children with cystic fibrosis.
        J Cyst Fibros. 2021;
        • Seshadri R.
        • Strane D.
        • Matone M.
        • Ruedisueli K.
        • Rubin D.M.
        Families with TRICARE report lower health care quality and access compared to other insured and uninsured families.
        Health Aff (Millwood). 2019; 38: 1377-1385
        • Knapp E.A.
        • Fink A.K.
        • Goss C.H.
        • Sewall A.
        • Ostrenga J.
        • Dowd C.
        • Elbert A.
        • Petren K.M.
        • Marshall B.C.
        The cystic fibrosis foundation patient registry. design and methods of a national observational disease registry.
        Ann Am Thorac Soc. 2016; 13: 1173-1179