J95-EPINATO based planning parameters for medical support to Operations Other Than War (OOTW)

As with increasing frequency the armies of NATO member states deploy on Operations Other Than War (OOTW), there is a requirement to define predictory variables of consumption of healthcare assets by type and geographical location of operations. This report presents the results of the analysis of the J95/EPINATO database of operational and exercise deployments. Although the database is limited in size and scope results show a marked difference in rates of incidence of EVENTS and in the proportion of first attendances to working days lost, both in general and when analysed by deployment type. For instance Service Assisted or Protected Evacuations (SA/PE) showed a relatively high incidence of first attendances and low incidence of working days lost for all reasons (or EVENTS) (214.5 per 1,000 personnel at risk per month-95% Confidence Interval-CI: 198.8 to 230.3 and 23.9 working days lost per 1,000 personnel at risk per month-95% CI 18.0 to 29.8). The reverse is true for Counter Insurgency (COIN) type operations (111.55 per 1,000 personnel at risk per month-95% CI: 110.9 to 112.2 and 161.25 working days lost per 1,000 personnel at risk per month 95% CI: 160.5 to 162.0). Other findings include highest attendance rates in exercise deployments for all reasons (264.7 per 1,000 personnel per month 95% CI: 261.2 to 268.1), highest hospitalisation rates in exercise and PSO deployments for all reasons (8.7 per 1,000 personnel per month 95% CI: 7.9 to 9.4 and 9.9 per 1,000 personnel per month 95% CI: 9.6 to 10.1) and the seasonal pattern, high incidence and low manpower impact (26.2 per 1,000 personnel per month 95% CI: 25.9 to 26.5 and 3.5 per 1,000 personnel per month 95% CI: 3.4 to 3.6) of dermatological consultations on all operational deployments (the lowest of the spectrum being in COIN operations). No relationship was found between incidence of consultations, working days lost, hospitalisations and distance of the deployment from the UK. Deployments to Africa show the highest incident of attendances and working days lost for all reasons (530.7 per 1,000 personnel per month 95% CI: 524.2 to 537.3 and 106.5 per 1,000 personnel per month 95% CI: 102.5 to 110.6). The variability in epidemiological profiles in this analysis demonstrates the dangers of exclusive reliance on synthetic classifications of reasons for attendances such as the traditional DNBI breakdown and on point estimates of incidence. As the database expands, further analysis will become possible.