Asthma Phase 2 Surveillance and Assessment of the revised recruiting standards

Research Project

Full description Background The Australian Defence Force (ADF) recognises that it is competing with a vast number of employers for competent people from within the domestic labour market. All applicants for the ADF are expected to have a high standard of health, which is necessary to perform their duties effectively, cope with rigorous demands of military life and to deploy anywhere in the world. However, the ADF must ensure that it does not preclude high quality candidates by ensuring that entry standards are regularly reviewed, based on current evidence and aligned with current best clinical practice. CMVH reviewed the medical recruitment standards for asthma and recommended enlisting personnel with intermittent or mild persistent asthma. Defence supported this amendment. Following enlistment, these members became part of a monitoring program to validate the amended recruitment criteria. Aims - To validate the revised recruitment standards for asthma to inform the Defence decision making process on recruitment, and determine whether or not it should be abandoned, retained or have scope to further relax the revised medical recruitment standard - To provide Defence with an assessment of whether health and administrative outcomes of asthmatics are significantly different to those of non-asthmatics Study design A retrospective audit of both clinical and administrative data over the first 12 months of enlistment in the ADF of three cohorts of recruits: Cohort 1: new recruits with a history of asthma within the last three years, but no current asthma symptoms or asthma medication (n=99). Cohort 2: new recruits with current mild asthma who are taking low dose asthma medication (n=221). Cohort 3: new recruits who have no history of asthma ever, or have had no asthma symptoms within the past three years (n=220). Key findings When assessing the health and productivity outcomes of recruits under the revised standards, there were very little, if any, differences between the three cohorts. While there was a small difference in the cost of prescription medication between the Current asthma and the No asthma groups, this may be accounted for by the identified cost of the asthma prescriptions required. When assessing administrative outcomes for the revised standards the results are mixed however overall they are positive. When assessing the attrition rate outcomes, a noticeable difference between the groups was found. The Current asthma group had higher attrition rates, particularly in the first three months of service, where 7% of recruits were discharged. It is unknown whether these attrition rates are statistically significantly different from the Previous asthma and No asthma groups as the numbers are too small to comprehensively analyse. There were no differences between the cohorts on deployment status as measured by MEC classification. Cumulatively, the results indicate that the adoption of the revised recruitment standards for asthma in the ADF has not resulted in unanticipated medical or administrative costs to the organisation.