Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2025
[Analysis of Sickness-Related Days of Absence among Soldiers of the German Armed Forces from 2008 to 2018 Part 2: Retrospective Analysis of Risk Factors for Long-Term Illnesses].
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Epple Kathrin, Schmidt Kristin, Löffler Christin, Feldmeier Gregor, Dierich Andreas
Аннотация
BACKGROUND: Long-term illnesses have far-reaching consequences for the patients themselves, as well as for society as a whole. The aim of this study was to analyze risk factors for long-term illnesses among soldiers of the German armed forces in order to derive target group-specific and risk-adapted prevention measures.
METHOD: The sick leaves of all soldiers of the German armed forces in the period 2008-2018 were analyzed descriptively and risk factors were determined using two-dimensional contingency tables for the attributes gender, military career group, age group and main diagnosis in relation to sick leave (>42 and>84 days), whereby a statistically significant odds ratio (OR)>1.00 (McNemar test, p<0.05) had to be present. Risk constellations were identified by linking risk factors with the three most common underlying ICD-10 diagnoses.
RESULTS: The age groups 30-39 years (OR 1.13; 95% confidence interval [1.10; 1.16]), 40-49 years (OR 1.50 [1.45; 1.54]), 50-59 years (OR 1.81 [1.74; 1.88]), the military career group of non-commissioned officers (OR 1.35 [1.32; 1.37]) and officers (OR 1 .26 [1.23; 1.30]), as well as female gender (OR 1.23 [1.19; 1.26]) were identified as risk factors. Main diagnoses from the ICD-10 chapters "mental and behavioral disorders (F-codes)" (OR 6.50 [6.35; 6.65]), "diseases of the musculoskeletal system (M-codes)" (OR 2.54 [2.48; 2.60]) and "injuries, poisoning and certain other consequences of external causes (S-T-codes)" (OR 3.37 [3.30; 3.45]) were also risk factors. The ICD-10 diagnoses "reactions to severe stress and adjustment disorders (F43)" and "depressive episode (F32)" were among the three most frequent diagnoses for all analyzed attributes. Non-commissioned officers with "knee injuries (S83)", officers with "intervertebral disc disorders (M51)" and women with "pregnancy complaints (O26)" were risk constellations.
CONCLUSION: In addition to the comprehensive relevance of diagnoses of "mental and behavioral disorders", the study identified further risk factors and risk constellations for long-term illnesses. Based on this results target group-specific and risk-adapted prevention measures can be developed, e. g. as part of company health management. Concepts for "women's health" should also be implemented in the future. The effects of target group-specific and risk-adapted prevention measures need to be analyzed in follow-up studies.
METHOD: The sick leaves of all soldiers of the German armed forces in the period 2008-2018 were analyzed descriptively and risk factors were determined using two-dimensional contingency tables for the attributes gender, military career group, age group and main diagnosis in relation to sick leave (>42 and>84 days), whereby a statistically significant odds ratio (OR)>1.00 (McNemar test, p<0.05) had to be present. Risk constellations were identified by linking risk factors with the three most common underlying ICD-10 diagnoses.
RESULTS: The age groups 30-39 years (OR 1.13; 95% confidence interval [1.10; 1.16]), 40-49 years (OR 1.50 [1.45; 1.54]), 50-59 years (OR 1.81 [1.74; 1.88]), the military career group of non-commissioned officers (OR 1.35 [1.32; 1.37]) and officers (OR 1 .26 [1.23; 1.30]), as well as female gender (OR 1.23 [1.19; 1.26]) were identified as risk factors. Main diagnoses from the ICD-10 chapters "mental and behavioral disorders (F-codes)" (OR 6.50 [6.35; 6.65]), "diseases of the musculoskeletal system (M-codes)" (OR 2.54 [2.48; 2.60]) and "injuries, poisoning and certain other consequences of external causes (S-T-codes)" (OR 3.37 [3.30; 3.45]) were also risk factors. The ICD-10 diagnoses "reactions to severe stress and adjustment disorders (F43)" and "depressive episode (F32)" were among the three most frequent diagnoses for all analyzed attributes. Non-commissioned officers with "knee injuries (S83)", officers with "intervertebral disc disorders (M51)" and women with "pregnancy complaints (O26)" were risk constellations.
CONCLUSION: In addition to the comprehensive relevance of diagnoses of "mental and behavioral disorders", the study identified further risk factors and risk constellations for long-term illnesses. Based on this results target group-specific and risk-adapted prevention measures can be developed, e. g. as part of company health management. Concepts for "women's health" should also be implemented in the future. The effects of target group-specific and risk-adapted prevention measures need to be analyzed in follow-up studies.