The patient flow of marine disease and nonbattle injury conditions within a multi-echelon system of care

Hospitalization data were extracted for Marines who incurred disease and nonbattle injuries in Vietnam from 1965 through 1969, and the inter-echelon movement of each patient who was hospitalized at an echelon II or III facility was tracked until the treatment was completed or until the patient was moved to a continental U.S. facility. The inter-echelon flow of treatment for different types of diagnosis categories was also examined. Results showed that approximately three-fourths of the patients admitted to echelon II or III facilities had no further treatment recorded at a higher echelon of care. Less than one-fifth of the patients required treatment at an echelon IV or echelon V facility. Of the major diagnostic categories, those with infective or parasitic diseases had the lowest percentage of patients treated at echelon IV or V facilities.