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Table 2 Cox proportional hazards model predicting VHA linkage among soldiers with chronic pain before military separation (n = 138,206) a

From: Predictors of Veterans Health Administration utilization and pain persistence among soldiers treated for postdeployment chronic pain in the Military Health System

  HR 95% CI P
Age 1.06 1.05–1.07 <  0.001
Female Sex (Ref. Male) 0.97 0.95–0.99 <  0.01
Race/ethnicity (Ref. non-Hispanic White)
 Black, not Hispanic 1.27 1.25–1.29 <  0.001
 Hispanic 1.14 1.12–1.16 <  0.001
 Other 1.03 1.01–1.05 <  0.001
Marital Status (Ref. Married)
 Never Married 1.04 1.02–1.05 <  0.001
 Other 1.06 1.04–1.09 <  0.001
Index Cohort (Ref. 2008)
 2009 1.03 1.01–1.05 <  0.001
 2010 1.07 1.05–1.09 <  0.001
 2011 1.10 1.08–1.13 <  0.001
 2012 1.14 1.11–1.18 <  0.001
 2013 1.23 1.19–1.29 <  0.001
 2014 1.12 1.04–1.21 <  0.01
Rank (Ref. Enlisted)
 Warrant Officer 0.82 0.79–0.86 <  0.001
 Commissioned Officer 0.76 0.74–0.78 <  0.001
Days deployed before index b 1.01 1.00–1.02 <  0.01
Days deployed after index b 1.02 1.01–1.02 <  0.001
Reason for separating (Ref. Expiration of enlistment)
 Disability 1.11 1.09–1.13 <  0.001
 Retirement 0.73 0.71–0.74 <  0.001
 Misconduct 0.80 0.78–0.83 <  0.001
 Poor Performance 1.12 1.09–1.15 <  0.001
 Other 0.89 0.87–0.91 <  0.001
Years of observation in MHS 1.04 1.03–1.04 <  0.001
PNS & CNS disorders 1.05 1.02–1.09 <  0.01
Osteoarthritis 1.04 1.01–1.07 <  0.05
Back & neck disorders 1.04 1.03–1.05 <  0.001
Headaches & migraines 1.09 1.07–1.11 <  0.001
Non-traumatic joint disorders 1.02 1.01–1.03 <  0.01
Other musculoskeletal disorders 1.00 0.99–1.02 0.34
Visceral & pelvic disorders 1.00 0.98–1.02 0.97
Wounds & injuries 0.98 0.96–1.00 0.10
Acute & post-operative diagnoses, trauma 1.09 1.02–1.16 <  0.01
Other diagnoses associated with pain 0.85 0.72–1.00 <  0.05
Chronic pain by ICD definition 1.03 1.02–1.05 <  0.001
Adjustment disorders 1.08 1.06–1.09 <  0.001
Depressive disorders 1.08 1.07–1.10 <  0.001
Anxiety disorders 1.10 1.08–1.11 <  0.001
Post-traumatic stress disorder 1.17 1.16–1.19 <  0.001
Traumatic brain injury 1.05 1.04–1.07 <  0.001
Alcohol use disorder 1.07 1.05–1.09 <  0.001
Substance use disorders 0.97 0.95–0.99 <  0.001
Days supply opioids c 1.08 1.07–1.10 <  0.001
Days supply tramadol c 1.06 1.04–1.07 <  0.001
Used mental health services 1.09 1.05–1.13 <  0.001
Used SUD services 1.05 1.00–1.11 0.06
Receipt of NPT for pain 1.03 0.99–1.06 0.10
Days supply opioids × NPT 0.96 0.95–0.98 <  0.001
Days supply tramadol × NPT 0.98 0.97–1.00 <  0.05
Used mental health services × NPT 1.04 1.00–1.08 0.05
Used SUD services × NPT 0.92 0.87–0.98 <  0.01
Pre-separation non-enrolled VHA utilization 2.20 2.17–2.23 <  0.001
  1. ‘Linkage to VHA’ was defined as enrolled and utilized VHA services after separating from the military
  2. Abbreviations: VHA Veterans Health Administration, HR Hazard Ratio, CI Confidence Interval, MHS Military Heath System, PNS Peripheral Nervous System, CNS Central Nervous System, ICD International Classification of Diseases, SUD Substance Use Disorder, NPT Nonpharmacological Treatment
  3. a If no unit or reference category is indicated, variable is dichotomous [No/Yes] with ‘No’ as reference
  4. b Expressed per 100 days
  5. c Expressed per year, averaged over the length of each service member’s observation window in the MHS