Determining USMC Medical Manpower Requirements

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Determining USMC Medical Manpower Requirements

• Jim Grefer
• Robert Levy
• 6 May 2008

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Study Objectives

• Estimate the number and types of medical
  personnel needed to provide appropriate care
  and minimize the number of casualties who die of
  wounds (DOW)
• Examine personnel implications of alternative
  medical networks
• Focus on the medical battalion
• Surgical Company
• Versus the Forward Resuscitative Surgical System
  (FRSS)

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Overall Approach

• Developed a realistic stressful combat scenario
  that flowed casualties through a USMC medical
  network
• Modeled the battlefield
• Assume a population at risk (PAR)
• We began with a USMC Regimental Combat Team (RCT)
• Dispersed RCT units and casualty stream were
  enough to generate workload for individual units
• Used Time, Task, Treater file to track medical
  outcomes in a realistic way through the medical
  network
• Used a model that ties the care provided to
  medical outcomes
• If personnel not available, patients more likely
  to die of wounds (DOW)

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Medical Staff to PAR ratios
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Medical support the medical battalion
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Generating a Combat Scenario

• Most scenarios used for medical modeling focus on
  requirements for theater hospitals
• Generate daily casualty streams to these
  platforms
• But for first response and flow through network,
  we needed casualties by unit and hour
• Otherwise little or no stress on medical network
• Developed casualty flows from current OIF data
  (USMC operations in Fallujah) during hot period
  in month of November 2004

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The Battle Scenario Casualty Rates in Fallujah
CASEST rates
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Flow of Patients Through The Medical Network
Medical flow chart first infantry battalion
Evacuate out of theater (to level 3)
Surgical Company (level 2)
Points of injury
FR Team (level 1A)
BAS (level 1B)
Four Medical Co. - 44 HM 8404
One BAS - 2 GMO - 21 HM 8404
One Infantry Battalion - 3 Rifle Cos. - 1
Weapons Co. - 1 H S Co. Total of 945 troops
One Surgical company - Triage/SST 4
Medical officers 14 HM 8404 - Operating
Room 18 Medical officers 12 OR
Techs - Ward 18 Medical officers
45 HM 8404
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Notional Survival Distributions
SBA self buddy aid
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Demand and supply of HMs at the BAS
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Demand and supply of GMOs at the BAS
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Simulation Results

• Alternative models vary medical personnel and
  network
• Current and reduced Table of Organization (TO)
• Surgical Company (402 medical personnel)
• Versus FRSS (359 medical personnel)
• Versus Reduced TO (185 medical personnel)
• Important results
• Medical personnel utilization rates
• Peak demands for medical personnel relative to
  supply
• Changes in DOW rates

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Results Peak Demand, Utilization, and Mortality
Rates
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Conclusions

• This methodology is useful for estimating
  manpower requirements
• Explicit medical outcome objective mortality
  rates
• Realistic casualty and treatment data to estimate
  personnel demand, supply, and utilization rates
• Our estimates of personnel reveal
• Current requirements for medical officers and
  surgical hospital corpsmen are appropriate
• But number of medical company and battalion aid
  station HMs requirements may be high
• Using the FRSS medical network leads to fewer
  requirements AND lower DOW rates

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• Questions?