Estimating Selected Disease and Non-Battle Injury Echelon 1 and Echelon 2 Outpatient Visits of U.S. Soldiers and Marines in an Operational Setting from Corresponding Echelon 3 (Hospitalizations) Admissions in the Same Theater of Operation
Uniformed Services University Of The Health Sciences Bethesda United States
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Non-hospitalized morbidity amongst deployed military forces can have adverse affects on military operations. This has been demonstrated throughout history from Napoleons typhus outbreak in the retreat from Moscow, to Merrills Marauders dysentery outbreak in Burma, and to the US Forces - Somalia dengue and malaria outbreak. Military medical planners do not have references to estimate the amount of Disease and Non-Battle Injury DNBI walking wounded. These walking wounded troops are personnel who have some level of morbidity, making them have less than an optimum level of health. This decrement in their optimum level of health may impact on their individual and collective ability to accomplish their military mission. These troops are not hospital admissions rather, they receive health care from an Echelon I or II healthcare facility, if at all. Currently, DNBI estimate systems focus on hospital logs and not battalion aid stations or medical company patient logs. As a result the vast majority of morbidity within military units is either overlooked or not estimated. Within the Theater of Operations, military hospitalization data by diagnosis category is normally available. If the corresponding outpatient morbidity in the force could be estimated from this data, the commander could better assess the health of the command and the mission readiness of the force. A tool for estimating these unreported DNBI cases is presented in this thesis. The data used in this analysis was gathered by the 227th Medical Detachment Epidemiology under the command of MAJ Jeff Gunzenhauser in Somalia from January to March 1993. This database contains both hospital admission data and outpatient visit data at Level I and Level II facilities for both the U.S. Marine Corps and the U.S. Army units in the Area of Operation.