Military deployment health surveillance and its application to United States Special Operations Forces: A policy analysis.

摘要

Since the promulgation of Public Law 105-85 and various supportive Department of Defense (DoD) policies and guidelines, which mandated deployment health surveillance, little has been accomplished to determine if these proposed polices and guidelines are meeting the intent of policy makers and expectations of the military members other than anecdotal evidence which indicates a system/program that is either fragmented or non-existent.; The primary objective of the study was to determine empirically whether or not military deployment health surveillance policy was implemented as intended by policy makers for Special Operations Forces (SOF). Additionally, implementation modifications were examined to further evaluate whether or not modifications improved policy outcomes so the intentions of policy makers and the expectations of the beneficiaries are achieved for this very important public health model for an occupational and environmental health surveillance program.; An evaluation research methodology was used which provided a systematic assessment of whether or not deployment health surveillance was operating in conformity with policy design for the specified target population—special operations forces, and whether or not implementation modifications (i.e., education, training and technology) would improve military deployment health policy compliance and goal achievement when applied to SOF. Per DoD and JCS policy and guidance, data for this methodology was based on pre- and post-deployment health assessments along with patient encounters collected during the deployments. The data was comprised of 1094 individual and unique SOF member information deployed to 11 different countries from October 2000 through December 2001.; Results from the study suggested that military deployment health surveillance policy goals for pre-deployment medical referrals, patient data capture and documentation during the deployment, and post-deployment medical referrals were not being achieved when DoD and JCS mandates were applied to SOF, but could be improved with the introduction of policy awareness education, training, and technology. Additionally, it was observed that without adequate patient encounter data capture and documentation at the point of care/exposure, significant medical information was lost that affected both the health care interest of the individual and the operational interest of the organization. Lastly, the necessity for a functional centralized data repository was validated.