A pilot study of J95 in secondary care in Bosnia.

The Army's morbidity reporting system J95 was fashioned into a secondary care variant and a pilot study conducted in Multinational Division South West (MND SW) during Operation Resolute 2. Some codes were modified, in keeping with the concurrent primary care J95a amendment, which included separating 'Other Injury' event codes further into 'Sports Injuries' and 'Other Injuries'. The collection system encompassed both out-patient and in-patient data and appropriate disposal categories such as 'admit' and 'length of stay' were introduced. Participating units included the Hospital Squadron at Sipovo, the Hospital facility at Tomislavgrad and, via a liaison officer, UK admissions and referrals to the Force Hospital near Split. A four month period of compatible data was found. Over this period 1,410 personnel (42.2/1,000/month) first attended out-patients with 337 requiring subsequent attendances (10.1/1000/month) and there were 425 admissions (12.7/1,000/month) from an average force level of 8,340 personnel. Nearly half the patients seen (49%) had orthopaedic problems and this group provided over half of the admissions (54%) and the bed occupancy (53%). There was a sizeable out-patient work load for the physician (28%). The pilot study showed that a J95 surveillance mechanism in secondary care was possible and informative. It gave indications of the impact of morbidity on the medical services and could help shape medical manning for future operations. It would be possible to adopt such a system in both the peacetime setting and in an international operational setting--in keeping with its primary care partner. It is recommended that J95 secondary variant should be continued on operations.