The patient flow of wounded marines within a multi-echelon system of care

Hospitalization data were extracted for Marines wounded in Vietnam from 1965 to 1969 to examine the echelon flow of treatment care for different types of injuries. The inter-echelon movement of each patient who was hospitalized at an echelon II or III facility was tracked until the treatment was completed or until the patient was moved to a facility in the continental United States. Results showed that approximately half of the admissions to echelon II or III facilities had no further treatment recorded at a higher echelon of care. Almost one-fourth of the patients required treatment at an echelon IV facility, and more than one-third were admitted to an echelon V facility.