Individual Medical Readiness

Each of the military services is responsible for maintaining the medical  readiness of its active-duty force. DOD’s IMR policy establishes six  elements for the military services to assess in order to determine a  servicemember’s medical readiness to deploy:  4.  individual medical equipment,5. Research Organizations

DOD and the military services have a number of organizations that fund  or conduct research, including research on health care issues that affect  those who have served in a combat zone. DOD’s Policies for Assessing Individual Medical Readiness Are Mainly Gender- Neutral but Include Some Aspects That Are Female-Specific

DOD’s policy establishes six elements for assessing the IMR of a  servicemember to deploy, most of which are gender-neutral. Four of the  six elements—immunization status, medical readiness laboratory tests,  individual medical equipment, and dental readiness—are gender-neutral;  they apply equally to female and male servicemembers. The remaining elements of IMR—deployment-limiting conditions and  PHAs—include some aspects that are specific to female  servicemembers. The Army, Navy, Air Force, and Marine Corps have  policies that define pregnancy as a deployment-limiting condition. Health Care and Behavioral Health Services Were Generally Available to Female Servicemembers through Domestic Army Installations

		Routine and Specialized Female-Specific Health Care Services Were Generally Available at the Domestic Army Installations We Reviewed or from Other Sources

On the basis of our survey, we found that most routine female-specific  health care services—including pelvic examinations, clinical breast  examinations, pap smears, screening mammographies, prescription of  contraceptives, and pregnancy tests—were available through the MTFs at  the 27 domestic Army installations with a primary MTF. On the basis of our survey, the availability of specialized health care  services varied by the type of primary MTF on the domestic Army  installation; however, when services were not available at the installation,  they were available through other MTFs or from a civilian network  provider. Additionally, both male and female  providers were available to provide specialized female-specific services— such as treatment of abnormal pap smear, prenatal care, labor and  delivery, benign gynecological disorders, and postpartum care—that were  offered at the 27 domestic Army installations. Officials from 18 of 27 domestic  Army installations provided examples of female-specific behavioral health  programs or activities, including a post-deployment group for female  servicemembers, postpartum groups, and specific therapy groups for  female servicemembers. One DOD Organization Is in the Process of Identifying Research Gaps on Health Care Needs for Female Servicemembers

The Women’s Health Research Interest Group, which is supported by the  TriService Nursing Research Program, is currently in the process of  identifying research gaps on health issues affecting female  servicemembers. Interest group officials said that the goal is to develop a repository for  peer-reviewed research articles related to health issues for female  servicemembers, including those who served in combat, and to use this  repository to identify research that could enhance the health care of  female servicemembers, including those who have served in a combat  zone. To ensure that researchers will have access to the results of their  work, officials have plans to distribute their results in presentations at  local and national conferences. In addition, officials told us that they will  disseminate their findings through peer-reviewed publications and post  this information on the TriService Nursing Research Program website,  which is available to the public. Agency Comments

We provided a draft of this report to DOD for comment. DOD responded  that it did not have any comments on the draft report. Appendix I: List of Domestic Army Installations with a Primary Military Treatment Facility

Appendix II: Scope and Methodology for the Survey Sent to Domestic Army Military Treatment Facilities

To describe the availability of routine, specialized, and behavioral health  care services to female servicemembers at domestic Army installations  and from other sources, we surveyed senior health care officials at the   27 domestic Army installations that had a primary military treatment  facility (MTF).
Why GAO Did This Study

Female servicemembers are serving in more complex occupational specialties and are being deployed to combat operations, potentially leading to increased health risks. Similar to their male counterparts, female servicemembers must maintain their medical readiness; however, they have unique health care needs that require access to gender-specific services. The National Defense Authorization Act for Fiscal Year 2012 directed GAO to review a variety of issues related to health care for female servicemembers. This report describes (1) the extent that DOD's policies for assessing individual medical readiness include unique health care issues of female servicemembers; (2) the availability of health care services to meet the unique needs of female servicemembers at domestic Army installations; and (3) the extent that DOD's research organizations have identified a need for research on the specific health care needs of female servicemembers who have served in combat.
GAO reviewed DOD and military-service policies on individual medical readiness and surveyed senior health care officials about the availability of specific health services at the 27 domestic Army installations with MTFs that report directly to the domestic regional medical commands. GAO focused on the Army because it has more female servicemembers than the other military services. GAO also visited six Army installations--two from each of the Army's three domestic regional medical commands--and interviewed DOD officials who conduct research on health issues for servicemembers.

What GAO Found

The Department of Defense's (DOD) policy for assessing the individual medical readiness of a servicemember to deploy establishes six elements to review, most of which are gender-neutral. Four of the six elements--immunization status, medical readiness laboratory tests, individual medical equipment, and dental readiness--apply equally to female and male servicemembers. The remaining elements of individual medical readiness--deployment-limiting conditions and periodic health assessments--include aspects that are specific to female servicemembers. For example, the Army, Navy, Air Force, and Marine Corps have policies that define pregnancy as a deployment-limiting condition.
Officials surveyed by GAO reported that female-specific health care services and behavioral health services were generally available through domestic Army installations. Specifically, according to GAO's survey results:
Most routine female-specific health care services--pelvic examinations, clinical breast examinations, pap smears, prescription of contraceptives, and pregnancy tests--were available at the 27 surveyed domestic Army installations.
The availability of specialized health care services--treatment of abnormal pap smears, prenatal care, labor and delivery, benign gynecological disorders, postpartum care, and surgical, medical, and radiation treatment of breast, ovarian, cervical, and uterine cancers--at the 27 surveyed domestic Army installations varied. However, when these services were not available at the installation, they could be obtained through either another military treatment facility (MTF) or from a civilian network provider.
The availability of behavioral health services, such as psychotherapy or substance abuse treatment, which were not gender-specific, varied across the 27 domestic Army installations; however, similar to specialty care, these services could be obtained from other MTFs or civilian network providers. In addition, 18 of the 27 surveyed Army installations reported offering female-specific programs or activities, such as a post-deployment group for female servicemembers or a postpartum group.
One DOD organization, the Women's Health Research Interest Group, is currently in the process of identifying research gaps on health issues affecting female servicemembers. Interest group officials said that the goal is to develop a repository for peer-reviewed research articles related to health issues for female servicemembers, including those who served in combat, and to use this repository to identify research that could enhance the health care of female servicemembers, including those who have served in a combat zone. To ensure that researchers will have access to the results of their work, officials have plans to distribute their results in presentations at local and national conferences. In addition, officials told GAO that they will disseminate their findings through peer-reviewed publications and post this information on the Internet to make it available to the public.
GAO provided a draft of this report to DOD for comment. DOD responded that it did not have any comments on the draft report.