Medical Redeployment in Soldiers With and Without Medical Deployment Waivers.

Abstract

Historically, disease and nonbattle injuries (DNBI) have caused more casualties during military operations than enemy combatants. Recent deployments to U.S. Central Commands (USCENTCOM) area of operation (AOR) have demonstrated similar outcomes. Intuitively, appropriate medical standards for our deploying Soldiers should result in no greater redeployments rates for those Soldiers who are waived for various medical conditions. However, no formal study has been published on redeployment rates of Soldiers with medical deployment waivers. The objective of this report was to evaluate the redeployment rates of Soldiers with and without medical waivers. A matched retrospective cohort study design was used in this study. Data were obtained from USCENTCOM, Army Central Command, Transportation Command, and the Armed Forces Health Surveillance Center. All U.S. Soldiers deploying to USCENTCOM's AOR with a medical deployment waiver during the calendar years of 2008-2013 were eligible for inclusion into the exposure group of this study. Soldiers with a medical deployment waiver were matched 1:5 to Soldiers without a medical deployment waiver. The Soldiers with a medical deployment waiver and their matched counterparts were then subdivided into 5 strata on the basis of their diagnosis. A McNemar's χ2 test was performed to calculate risk ratios (RRs) per strata and for the group as a whole. The overall risk of being medically evacuated because of DNBI for all medical deployment waivers was an RR of 2.03 (CI: 1.74, 2.36). The greatest risk of being medically evacuated because of DNBI was from the group of Soldiers on a waiver for neurological conditions with an RR of 3.81 (CI: 1.99, 7.30). The RR of medical evacuation because of DNBI was increased and statistically significant for all strata (p < 0.05). There is a statistically significant increased RR of Soldiers with a Modification of the Operational Order waiver being medically redeployed for a DNBI reason from USCENTCOM's AOR from 2008 to 2013 compared with their matched peers without a waiver. The results of this study provide Commanders with additional information when making decisions regarding Soldier deployment.