Online Program

Evaluation of prevalence, healthcare costs, and utilization associated with musculoskeletal conditions in a military population over time and by gender

Sunday, November 3, 2013

Michelle Kloc, Ph.D., MSN, RN, Evaluation and Measurement, Altarum Institute, Alexandria, VA
Joseph Dorris, MA, Altarum Institute, Ann Arbor, MI
Diana Jeffery, Ph.D., Defense Health Cost Assessment and Program Evaluation, TRICARE Management Activity, Falls Church, VA
Charles Roehrig, Ph.D., Center for Sustainable Health Spending, Altarum Institute, Ann Arbor, MI
Objective This study examines the prevalence, healthcare use and costs associated with musculoskeletal disorders among Active Duty and Non-Active Duty Military Health System (MHS) beneficiaries through use of descriptive statistics and trend analyses.

Methods Claims data were obtained from the MHS Master Data Repository for claims for which TRICARE was a payor. Primary ICD9 codes for person-level encounters were grouped into clinical condition categories using Academy of Healthcare Research and Quality Clinical Classification Software. MHS beneficiaries ages 18-64 alive and residing within the United States (excluding Alaska) for Fiscal Years 2006-2010 were included.

Results Musculoskeletal disorders demonstrate high prevalence, cost, and utilization levels, with significant observed trend rates over time, relative to other conditions among the MHS population. Encounters for back problems (BP) increased 424,000 per year followed by connective tissue disorders visits (204,000 per year). The real increase in cost, controlling for inflation, for BP was $51 million per year. Female Active Duty Service members exhibit 50% higher prevalence rates for BP than their male counterparts.

Conclusions Both Active Duty and Non-Active Duty male and female Service members frequently access healthcare services for musculoskeletal conditions. These findings are unique to a military population and may be due to the physically demanding occupational needs of military service which maintains strict readiness and fitness requirements. Evidence suggests that BP may follow active duty Service members into their retirement. During active duty Service, prevalence rates for BP are approximately 1 in 9 (2007 civilian musculoskeletal prevalence: 1 in 29).

Learning Areas:

Occupational health and safety

Learning Objectives:
List key occupational related health conditions for military personnel. Articulate the gender and long-term impact of occupational-related health conditions.

Keyword(s): Occupational Health, Gender

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the associate investigator on this federally funded project, focusing on the prevalence, health care costs and utilization of military health system beneficiaries. I have been the lead researcher and project manager for another federally funded program with research including analysis of satisfaction survey data, healthcare use and costs and prevalence of select conditions of interest, and analysis of predictors of prescription substance abuse in military populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.