Defence Health Care Organization, Netherlands Armed Forces, Herculeslaan 1, 3584AB, Utrecht, The Netherlands.
Clinical Epidemiology, Biostatistics and Bioinformatics, Master Evidence Based Practice in Health Care, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.
Mil Med. 2020 Mar 2;185(3-4):e480-e486. doi: 10.1093/milmed/usz328.
Musculoskeletal injuries (MSIs) have direct impact on occupational readiness and task performance in military populations. Until this date, no epidemiologic data have been published concerning MSI incidence in the Netherlands Armed Forces (NAF). The aim of this study was to assess the MSI incidence and related costs in the NAF.
In this descriptive epidemiologic study, we collected injury surveillance data from the electronic patient records of multiple military units of the NAF. Using data of all new consultations with a military physician from January 1, 2014 to December 31, 2016, we calculated MSI incidence rates per 100 person-years, with a 95% confidence interval (CI). Physician care costs were determined based on the number of physician consults and the charge per appointment. We used two methods to determine productivity costs; the top-down microcosting method and the friction cost method.
Our study sample included 22% (n = 8,847) of the total NAF population of 2016 (n =40,178). In this sample, consultations of MSIs accounted for 23.2% (n = 7,815) of all new consultations (n = 33,666). MSI incidence rates per unit ranged from 12.5 to53.3 per 100 person-years. In the total sample, MSI incidence rates were highest in the back (6.73, 95% CI 6.39-7.10), knee (5.04, 95% CI 4.74-5.35), and foot (4.79, 95% CI 4.50-5.10). The estimated costs for physician visits for MSIs in our sample were €0.69 million. Limited duty days accounted for €1.10 million productivity costs using top-down microcosting method.
Our study provided evidence that MSIs result in substantial financial burden. Injuries of the back, knee, and foot account for the majority of demands on curative care for MSIs.
肌肉骨骼损伤（MSI）对军事人群的职业准备和任务表现有直接影响。迄今为止，尚无关于荷兰武装部队（NAF）MSI 发病率的流行病学数据。本研究旨在评估 NAF 中的 MSI 发病率和相关成本。
在这项描述性流行病学研究中，我们从 NAF 多个军事单位的电子患者记录中收集了伤害监测数据。使用 2014 年 1 月 1 日至 2016 年 12 月 31 日期间所有与军医新就诊的患者数据，我们计算了每 100 人年的 MSI 发病率，置信区间（CI）为 95%。根据就诊次数和每次就诊的费用确定医生护理费用。我们使用两种方法来确定生产力成本；自上而下的微观成本法和摩擦成本法。
我们的研究样本包括 2016 年 NAF 总人口的 22%（n=8847）（n=40178）。在该样本中，MSI 就诊占所有新就诊（n=33666）的 23.2%（n=7815）。单位 MSI 发病率范围为每 100 人年 12.5 至 53.3。在总样本中，背部（6.73，95%CI 6.39-7.10）、膝盖（5.04，95%CI 4.74-5.35）和脚部（4.79，95%CI 4.50-5.10）的 MSI 发病率最高。我们样本中用于 MSI 医生就诊的估计费用为 69 万欧元。使用自上而下的微观成本法，有限的工作日导致 110 万欧元的生产力成本。
我们的研究提供了证据表明，MSI 会造成巨大的财务负担。背部、膝盖和脚部受伤是对 MSI 治疗需求的主要原因。
