DOD Health Care: Requirements for Emergency Services Adequate and Generally Attainable

The three major military services operate 164 hospital emergency rooms, which provide services primarily to military beneficiaries. During fiscal year 1986, the most recent year for which complete data were available, about 3.7 million people were treated in military hospital emergency rooms. According to military officials, 10 percent or fewer of these visits involved life- or limb-threatening emergencies. The directive sets different requirements for emergency rooms based on their designated level of care. Each military hospital designates a level of care for its emergency room based on standards established by the Joint Commission on Accreditation of Healthcare Organizations (formerly the Joint Commission on Accreditation of Hospitals). The Joint Commission sets standards for emergency rooms at levels I through IV, with level I furnishing the most comprehensive services and capable of handling the most complex cases. / Differences in levels are determined by various factors, including the qualifications and availability of physicians on the medical staff, number of nurses in the emergency room, type of services supporting the emergency room, hospital operating room capability, and equipment.