Age-focused evaluation of prevalence, healthcare costs, and utilization, by CCS condition, in the military health system

Objective This study examines the prevalence, healthcare use and costs associated with increasing age among 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 (FY) 2006-2010 were included.

Results Back Problems (BP) are the highest cost and utilization condition for ages 35-44 and 45-64; those 45-64 demonstrate double the prevalence, utilization and costs for BP of their younger cohort. Real increase in BP cost for ages 45-64 was $21.5 million per year (average, inflation controlled). Other high-cost conditions for ages 45-64 include: Connective Tissue, Osteoarthritis, Rehab, Joint conditions, Chest Pain and Coronary Atherosclerosis. Musculoskeletal (Sprain, BP, Connective Tissue, Joint conditions and Rehab) and mental health (Mood and Adjustment disorders) conditions were consistently within the ten highest cost and utilization conditions for ages 35-44. High cost/use conditions for 18-24 and 25-34: pregnancy-related, Musculoskeletal, Mental Health and Anxiety disorders.

Conclusions Service members aged 35-64 frequently access healthcare services for Musculoskeletal conditions. Evidence suggests that Musculoskeletal problems may follow active duty Service members into their retirement. Younger Service members demonstrate high utilization and high associated costs for a variety of mental health conditions, perhaps related to recent war efforts.