2013 Issues   /   February 2013

Iraq and Afghanistan Wars Placed Heavy Burden on Active-Duty Medical Services

USM By U.S. Medicine
February 8, 2013

By Sandra Basu

WASHINGTON — How much burden have the wars in Iraq and Afghanistan put on the military healthcare system?  A recent report suggests the effects have been significant and they will not end anytime soon.

Since the beginning of the wars in Afghanistan and Iraq, there have been approximately 17 million more ambulatory visits, 67,000 more hospitalizations and 635,000 more hospital bed days among active component military members than would have occurred if the pre-war experience had continued, according to the report, published in the Armed Forces Heath Surveillance Center’s Medical Surveillance Monthly Report.

Patients in the waiting room at the Monroe Health Clinic at Fort Hood, TX. The facility was renovated and reopened last year.

The authors arrived at this conclusion by estimating the numbers of excess medical encounters of active component members since the beginning of war-fighting in Afghanistan and Iraq.

“Clearly, if all war-related healthcare — since the beginning of the war until the last war veteran dies — could be accounted for, the healthcare burden attributable to the war would be much greater than that documented in this report,” the report stated.

Mental disorders accounted for nearly two-thirds of the estimated excess hospitalizations during the war period. Mental disorders and injuries/poisonings accounted for approximately 90% of all estimated excess hospital bed days.

“The predominance of these causes of excess hospitalizations and hospital bed days is not surprising, because they directly reflect the natures, durations and intensities of the combat in Afghanistan and Iraq as well as the psychological stresses associated with prolonged and often repeated combat deployments,” the report stated.

The report also noted that during the war period, crude rates of ambulatory visits, hospitalizations and hospital bed days were higher among troops who were female, in the Army, black non-Hispanic and in healthcare occupations compared to their respective counterparts.

While the healthcare demand may have gone up when the conflicts began, the authors concluded that the healthcare burden “will not return to prewar levels immediately after the cessation of war.”

“During the wars in Afghanistan and Iraq, many military members sustained injuries that may not have precluded the continuation of active service but do require continuing medical care (e.g., clinical follow-ups, treatment of complications, rehabilitation),” they wrote. “Until all such individuals leave active military service, the cumulative costs of war-related healthcare will increase.”

The authors suggested that the findings of the report should be “interpreted with careful consideration of the objectives and inherent limitations of the analyses.”

“The total healthcare burdens associated with the wars in Afghanistan and Iraq are undoubtedly greater than those enumerated in this report because this analysis did not address care delivered in deployment locations or at sea, care rendered by civilian providers to reserve component members in their home communities, care of veterans by the Departments of Defense and Veterans Affairs, preventive care for the sake of force health protection and future healthcare associated with wartime injuries and illnesses,” according to the authors.


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