A Public Health Approach to Injury Prevention: The U.S. Military Experience

TITLE: A Process to Identify Military Injury Prevention Priorities Based on Injury Type and Limited Duty Days. BACKGROUND: Injuries, one of the leading public health problems in an otherwise healthy military population, affect operational readiness, increase healthcare costs, and result in disabilit...

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Bibliographic Details
Main Authors: Canham-Chervak, Michelle, Jones, Bruce H, Sleet, David A, Bullock, Steven H, Burnham, Bruce R, Rennix, Christopher P, Wells, Timothy S, Smith, Jack W, Ruscio, Bruce A
Format: Report
Language:English
Subjects:
CASUALTIES
COSTS
DATA MANAGEMENT
DEFENSE SYSTEMS
HEALTH CARE MANAGEMENT
IDENTIFICATION
MEDICAL SERVICES
Medicine and Medical Research
MILITARY PERSONNEL
MUSCULOSKELETAL DISEASES
OPERATIONAL READINESS
PHYSICAL DISABILITIES
PREVENTION
PUBLIC HEALTH
REPRINTS
SAFETY
SURVEILLANCE
Weapons Effects(biological)
WOUNDS AND INJURIES
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Summary:TITLE: A Process to Identify Military Injury Prevention Priorities Based on Injury Type and Limited Duty Days. BACKGROUND: Injuries, one of the leading public health problems in an otherwise healthy military population, affect operational readiness, increase healthcare costs, and result in disabilities and fatalities. This paper describes a systematic, data-driven, injury prevention-decision making process to rank potential injury prevention targets. METHODS: Medical surveillance and safety report data on injuries for 2004 were reviewed. Non-fatal injury diagnoses (ICD-9-CM codes) obtained from the Defense Medical Surveillance System were ranked according to incident visit frequency and estimated limited duty days. Data on the top five injury types resulting in the greatest estimated limited duty days were matched with hospitalization and Service Safety Centers' accident investigation data to identify leading causes. Experts scored and ranked the causes using predetermined criteria that considered the importance of the problem, preventability, feasibility, timeliness of intervention establishment/results, and ability to evaluate. Department of Defense (DoD) and Service-specific injury prevention priorities were identified. RESULTS: Unintentional injuries lead all other medical conditions for number of medical encounters, individuals affected, and hospital bed days. The top ten injuries resulted in an estimated 25 million days of limited duty. Injury-related musculoskeletal conditions were a leading contributor to days of limited duty. Sports and physical training were the leading cause, followed by falls. Published in the American Journal of Preventive Medicine, v38 n1 supp1 pS19-S33, Jan 2010. Prepared in cooperation with Air Force Safety Center, Kirtland AFB, NM; Office of the Assistant Secretary of Defense for Health Affairs, Falls Church, VA; and others.