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Understanding Treatment of Mild Traumatic Brain Injury in the Military Health System

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Technical Report

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RAND Corporation National Defense Research Institute Santa Monica United States

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Traumatic brain injury TBI has become a signature injury of modern warfare. For example, and although estimates vary, during operations in Iraq and Afghanistan, approximately 820 percent of service members may have experienced a TBI, with the majority 84 percent being diagnosed as mild in severity. Many service members who have experienced a mild TBI mTBI, also known as a concussion, receive care through the Military Health System MHS. However, there have been no publicized, large-scale studies of the frequency and nature of post-injury health care use by service members diagnosed with an mTBI. To address this gap, the U.S. Department of Defense DoD asked the RAND Corporation to survey the current landscape of mTBI treatment across the MHS. Using the available data, the RAND study focused specifically on nondeployed active-duty service members. The goal of this research is to provide timely information to DoD that can be used to help assess and improve care for service members with an mTBI. This report is the first of its kind to describe the characteristics of nondeployed active duty service members who have received an mTBI diagnosis, their co-occurring symptoms and conditions, the locations where they received care, the types of treatment and medications they received, and the duration and patterns of their care. The analysis draws on individual level health care utilization data managed and maintained by the Defense Health Agency, along with administrative data on service member characteristics, to identify and characterize nondeployed active-component service members who received treatment for mTBI in calendar year 2012 and the treatment they received through the MHS. The research team began by selecting a case definition for mTBI based on codes in the International Classification of Diseases, Ninth Revision ICD-9, Clinical Modification.

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