Defense Health Care: Quality Assurance Process Needed to Improve Force Health Protection and Surveillance Page: 2 of 44
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- GAO
' Accountability* Integrity* Reliability
Highlights
Highlights of GAO-03-1041, a report to the
Chairman and Ranking Minority Member,
Subcommittee on Total Force, Committee
on Armed Services, House of
Representatives
Why GAO Did This Study
Following the 1990-91 Persian Gulf
War, many servicemembers
experienced health problems that
they attributed to their military
service in the Persian Gulf.
However, a lack of servicemember
health and deployment data
hampered subsequent
investigations into the nature
and causes of these illnesses.
Public Law 105-85, enacted in
November 1997, required the
Department of Defense (DOD) to
establish a system to assess the
medical condition of service
members before and after
deployments. GAO was asked to
determine whether (1) the military
services met DOD's force health
protection and surveillance
requirements for servicemembers
deploying in support of Operation
Enduring Freedom (OEF) in
Central Asia and Operation Joint
Guardian (OJG) in Kosovo and
(2) DOD has corrected problems
related to the accuracy and
completeness of databases
reflecting which servicemembers
were deployed to certain locations.
GAO recommends that the
Secretary of Defense direct the
Assistant Secretary of Defense
for Health Affairs to establish an
effective quality assurance program
that will help ensure that the
military services comply with the
force health protection and
surveillance requirements for
all servicemembers. DOD
concurred with the
recommendation.
www.gao.gov/cgi-bin/getrpt?GAO-03-1041.
To view the full product, including the scope
and methodology, click on the link above.
For more information, contact Cliff Spruill at
(202) 512-4531.DEFENSE HEALTH CARE
Quality Assurance Process Needed
to Improve Force Health Protection
and Surveillance
What GAO Found
The Army and Air Force-the focus of GAO's review-did not comply with
DOD's force health protection and surveillance policies for many active duty
servicemembers, including the policies that they be assessed before and
after deploying overseas, that they receive certain immunizations, and that
health-related documentation be maintained in a centralized location.
GAO's review of 1,071 servicemembers' medical records from a universe of
8,742 at selected Army and Air Force installations participating in overseas
operations disclosed that 38 to 98 percent of servicemembers were missing
one or both of their health assessments and 14 to 46 percent were missing at
least one of the required immunizations (see figure).
DOD also did not maintain a complete, centralized database of
servicemembers' medical assessments and immunizations. Health-related
documentation missing from the centralized database ranged from 0 to
63 percent for pre-deployment assessments, 11 to 75 percent for
post-deployment assessments, and 8 to 93 percent for immunizations.
There is no effective quality assurance program at the Office of the Assistant
Secretary of Defense for Health Affairs or at the Army or Air Force that
helps ensure compliance with policies. GAO believes that the lack of such a
program was a major cause of the high rate of noncompliance. Continued
noncompliance with these policies may result in servicemembers deploying
with health problems or delays in obtaining care when they return. Finally,
DOD's centralized deployment database is still missing the information
needed to track servicemembers' movements in the theater of operations. By
July 2003, the department's data center had begun receiving location-specific
deployment information from the services and is currently reviewing its
accuracy and completeness.
Percent of Servicemembers Missing One or Both Health Assessments, and Missing at Least
One Required Immunization
100 In percentI
Fort Campbell Fort Campbell Fort Drum
(OEF) (OJG) (OEF)Fort Drum Hurlburt Field Travis AFB
(OJG) (OEF) (OEF)Installation/deployment
Health assessments Immunizations
Sources: GAO analyses of DOD data.United States General Accounting Office
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United States. General Accounting Office. Defense Health Care: Quality Assurance Process Needed to Improve Force Health Protection and Surveillance, report, September 19, 2003; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc290944/m1/2/: accessed April 19, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.