Question 9766 — defense

Summary

Monitoring the injured within the armed forces requires having quantified data, the analysis of which makes it possible to improve the medical care and reintegration of these soldiers. To this end, the army health service (SSA) had already had consolidated data for many years, such as the number of soldiers injured and evacuated from theaters of operations, according to the degree of emergency and according to the illness or trauma. initial. Epidemiological surveillance of the armies also made it possible to obtain precise information on soldiers injured by weapons or explosive devices, presenting a psychological disorder in relation to a traumatic event or victims of noise trauma. All this data nevertheless remained fragmented and did not provide a comprehensive view of the situation. The SSA in particular had little data when soldiers were no longer cared for by military health establishments, which could lead to a break in follow-up. Fully aware of its duties towards the military who serve the Nation sometimes at the cost of their physical and psychological integrity, and following information report No. 2470 of December 16, 2014 filed by the National Defense and Armed Forces Committee of the National Assembly in conclusion of the work of an information mission on the care of the wounded, the SSA has been resolutely committed since 2015 to the establishment of a military health observatory. From this perspective, it was necessary to identify the different sources of data available both within the Ministry of the Armed Forces and outside (in particular the national health data system - SNDS). It was also necessary to define the terms of access to data in compliance with current regulations and good public health practices. Indeed, the very high mobility of active military personnel, both on the national territory and in theaters of operations, the multiplicity of health care providers (medical sector with general and hospital health professionals, military and civilians, medico-social sector and social sector) had the consequences of both increasing and dispersing the data necessary to characterize the state of health of soldiers in general and of the wounded in particular. As the military health observatory project has reached sufficient maturity, all the participating services of the ministry have been requested, from April 2018, to support and support the SSA in the implementation of this new system. Put in implemented by the Armed Forces Epidemiology and Public Health Center (CESPA), the military health observatory will be made up of several data sources which will therefore be operational very soon. Thus, the Register of Technical Acts in Operations (ReAcTO), deployed by the end of 2018, will offer the possibility of detailing the entire medical care of soldiers from the theaters of operations until their possible medical evacuation to an army training hospital on national territory. During 2019, the new major survey, carried out jointly by the SSA and the national military social security fund to which all soldiers are affiliated, will make it possible, from a representative sample of 5,000 soldiers drawn at random from around fifty military units, to describe the perceived state of health of soldiers, health events that occurred during the last external operation and prevention needs. This survey, which is fully in line with the ministry's family plan, will include a “families” component and will explore in particular the impact of the state of health of soldiers on their family circle. Finally, the CSESaM system (Consumption of Healthcare and State of Health of Soldiers), which will be fully operational before the end of 2021, will make it possible, thanks to SNDS data, to characterize the state of health of military personnel based on their healthcare consumption (medication consumption, consultations, hospitalizations in mainland France) and to identify risk factors and circumstances, in order to implement specific preventive actions. The entire system will be based on the supported computerized medical record by the CMA digital project (AXONE), future tool for managing individual medical data. Its complete implementation and connected to other medical information systems conditions the possibility of giving a precise description of the state of health of soldiers. The military health observatory, a major ministerial project, thus responds to the ambitions of the Ministry of the Armed Forces aimed at having consolidated data concerning all of the injured, and in particular the characteristics of the injuries suffered or illnesses contracted in the service of the Nation. Knowledge of the state of health of military personnel will enable the implementation of more effective, targeted prevention actions that are particularly adapted to the conditions of military employment.

Machine translation from French. The official text remains authoritative.

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