ABSTRACT
The aggregate numbers and rates of ambulatory care visits by active component service members in 2021 were the highest of the previous ten years. Most disease and injury categories experienced slight increases in both rates and numbers. From 19% of ambulatory care visits in 2020 to less than 15% in 2021, telehealth contacts were used less frequently. The statistics for 2021 demonstrate a return to pre-pandemic levels, notwithstanding the possibility that the response to the COVID-19 pandemic in 2020 was related with declines in the incidence of disease and injury diagnoses in the community of service members seeking ambulatory care. Additionally, the proportions of telehealth-delivered medical encounters have similarly decreased to the lower levels seen before the pandemic. Lessons learned may direct future actions to lower the frequency of disease and harm in the post-pandemic era. This study details the ambulatory health care visits made by active component members of the U.S. Army, Navy, Air Force, and Marine Corps in 2020 in terms of frequency, rates, trends, and other factors. U.S. service members' ambulatory visits to fixed military and nonmilitary medical treatment facilities (reimbursed through the Military Health System [MHS]) are recorded in standardized, computerized records. The Defense Medical Surveillance System (DMSS), the data source for this report, routinely archives these records for health surveillance purposes. This research excludes ambulatory visits that are not frequently and fully recorded using standardized electronic records (for example, during deployments, field training exercises, or at sea). As in previous MSMR reports, the primary (first-listed) diagnostic position of the visit records was used to categorize all records of ambulatory visits of active component service members according to the first four characters of the ICD-10 codes. In this research, a specific query of the DMSS records was carried out to identify ambulatory visits that were completed via "telehealth" encounters rather than in-person meetings (e.g., via telephone or video conferencing). Most data summaries included both types of encounters and did not make a distinction between them, however due to the rise in telehealth encounter usage during the coronavirus 2019 (COVID-19) pandemic, changes in the proportions of telehealth encounters were examined.