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

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).