Capturing and Categorizing the Burden of Musculoskeletal Injuries in U.S. Active Duty Service Members: A Comprehensive Methodology.

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Veronika Pav, Xiaoning Yuan, Brad Isaacson, Wendy Funk, Ben Hando
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引用次数: 0

Abstract

Background: Musculoskeletal injuries (MSKIs) represent the most common, costly, and impactful medical conditions affecting active duty service members (ADSMs) of the United States Armed Forces. Inconsistent, variable MSKI surveillance methods and often incompletely described criteria for cohort selection, injuries, incidence, and prevalence have limited efforts to observe longitudinal trends, identify gaps in care, or highlight specific military branches or sites that could benefit from enhanced MSKI intervention protocols. The purpose of this manuscript is to present a comprehensive, well-documented, and reproducible framework for capturing and categorizing MSKI burden, healthcare utilization, and private sector costs for ADSMs across a 12-year period spanning the International Classification of Diseases, 10th Revision, Clinical Modification transition.

Methods: This was a retrospective, longitudinal population study, including ADSMs from the Air Force, Army, Marine Corps, and Navy. Prevalence and incidence rates for Upper Extremity, Lower Extremity, Spine, and Head/Neck MSKIs, associated health care utilization, and private sector costs were obtained by querying electronic health records from military treatment facilities, private sector care (PC) claims, and theater medical data from October 1, 2010 to September 30, 2021 (Fiscal Years 10-21), using the Military Health System Data Repository. Utilization associated with MSKIs per body region in the direct care and PC settings was classified into mutually exclusive outpatient encounter categories and acute inpatient stays. PC MSKI-associated costs were captured per year and categorized by service, body region, and setting.

Conclusions: MSKI surveillance research in ADSMs has been impacted by variable, often incompletely described methods. While our approach is not without limitations, our aim was to present a well-documented, reproducible methodology for MSKI investigation in military personnel. By presenting a comprehensive blueprint for capturing and categorizing MSKI care in U.S. service members, our goal is for this methodology to enhance the efforts of researchers, public health officials, and Military Health System leaders to combat MSKIs, the primary medical threat to military readiness.

美国现役军人肌肉骨骼损伤负担的捕捉和分类:综合方法。
背景:肌肉骨骼损伤(MSKIs)是影响美国武装部队现役军人(ADSMs)最常见、最昂贵、影响最大的医疗状况。由于 MSKI 监测方法不一致、多变,而且对队列选择、损伤、发病率和流行率的标准描述往往不完整,因此限制了观察纵向趋势、确定护理差距或强调可从加强 MSKI 干预方案中受益的特定军种或地点的工作。本手稿旨在提供一个全面、记录详实且可重复的框架,用于捕捉和分类ADSM在12年期间的MSKI负担、医疗保健利用率和私营部门成本,时间跨度为《国际疾病分类》第10版临床修订过渡时期:这是一项回顾性纵向人群研究,包括来自空军、陆军、海军陆战队和海军的 ADSMs。通过查询军队治疗机构的电子健康记录、私营部门的护理(PC)索赔以及战区医疗数据(2010 年 10 月 1 日至 2021 年 9 月 30 日(第 10-21 财年)),并使用军事健康系统数据存储库,获得了上肢、下肢、脊柱和头颈部 MSKI 的流行率和发病率、相关的医疗保健使用情况以及私营部门的成本。在直接医疗和私人医疗机构中,与每个身体区域的 MSKI 相关的使用情况被划分为相互排斥的门诊就诊类别和急性住院治疗类别。与 PC MSKI 相关的费用按年统计,并按服务、身体部位和环境进行分类:ADSM中的MSKI监测研究受到了各种方法的影响,这些方法往往描述不全。虽然我们的方法并非没有局限性,但我们的目标是为军事人员的 MSKI 调查提供一种有据可查、可重复的方法。通过提出一个全面的蓝图来捕捉和分类美国现役军人的 MSKI 护理,我们的目标是让这一方法加强研究人员、公共卫生官员和军事卫生系统领导者的努力,以对抗 MSKI 这一军事战备的主要医疗威胁。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Military Medicine
Military Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
2.20
自引率
8.30%
发文量
393
审稿时长
4-8 weeks
期刊介绍: Military Medicine is the official international journal of AMSUS. Articles published in the journal are peer-reviewed scientific papers, case reports, and editorials. The journal also publishes letters to the editor. The objective of the journal is to promote awareness of federal medicine by providing a forum for responsible discussion of common ideas and problems relevant to federal healthcare. Its mission is: To increase healthcare education by providing scientific and other information to its readers; to facilitate communication; and to offer a prestige publication for members’ writings.
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