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The military will downsize its hospitals in Naples, shown here, as well as in Sigonella and Aviano, turning them into outpatient clinics by fiscal 2019 under a recent Pentagon decision.

The military will downsize its hospitals in Naples, shown here, as well as in Sigonella and Aviano, turning them into outpatient clinics by fiscal 2019 under a recent Pentagon decision. (U.S. Navy)

The military will downsize its hospitals in Naples, shown here, as well as in Sigonella and Aviano, turning them into outpatient clinics by fiscal 2019 under a recent Pentagon decision.

The military will downsize its hospitals in Naples, shown here, as well as in Sigonella and Aviano, turning them into outpatient clinics by fiscal 2019 under a recent Pentagon decision. (U.S. Navy)

The military will downsize its hospitals in Naples, Sigonella, shown here, and Aviano, turning them into outpatient clinics by fiscal 2019 under a recent Pentagon decision. The Navy surgeon general says no decision has been made about how to downsize base hospitals in Naples and Sicily.

The military will downsize its hospitals in Naples, Sigonella, shown here, and Aviano, turning them into outpatient clinics by fiscal 2019 under a recent Pentagon decision. The Navy surgeon general says no decision has been made about how to downsize base hospitals in Naples and Sicily. (U.S. Navy)

The Army Health Care Center in Vicenza, Italy. The military will downsize its hospitals in Naples, Sigonella and Aviano into outpatient clinics by fiscal 2019 under a recent Pentagon decision.The new decision follows the 2014 closure of a birthing center at the Army post in Vicenza, Italy, six years after it opened, a move described by military leaders as a cost-savings measure.

The Army Health Care Center in Vicenza, Italy. The military will downsize its hospitals in Naples, Sigonella and Aviano into outpatient clinics by fiscal 2019 under a recent Pentagon decision.The new decision follows the 2014 closure of a birthing center at the Army post in Vicenza, Italy, six years after it opened, a move described by military leaders as a cost-savings measure. (Nancy Montgomery/Stars and Stripes)

NAPLES, Italy — The military will downgrade three of its hospitals in Italy to outpatient clinics within the next three years.

Navy hospitals in Naples and Sigonella, Sicily, and the Air Force hospital at Aviano Air Base will stop providing inpatient services by fiscal 2019, Deputy Defense Secretary Robert Work said in a December memo. That will send more patients to off-base hospitals.

The loss of on-base labor and delivery and admissions for internal medicine and general surgery would appear to be the biggest changes brought by the move, as each hospital already sends serious cases and patients requiring advanced procedures to off-base hospitals.

The changes are part of a broader Pentagon review of medical facilities and patient volumes across Europe, said Air Force Maj. Ben Sakrisson, a Defense Department spokesman. Medical specialists working in areas with low need have a hard time maintaining their skills, he said. Off-base hospitals can fill gaps in care.

“The key point here is we’re working with local providers to continue ready access to high-quality care,” he said.

Each hospital’s medical command will implement the changes.

Navy Medicine spokeswoman Capt. Dora Lockwood said her command is in the earliest stage of the process. Changes have yet to be made in Naples and Sigonella, she said, and the process ahead is only now being mapped out.

“At this point I cannot begin to speculate what services are going to be available and what services may transition to other facilities,” she said. “The bottom line is we’re looking very closely at how to ensure our patient needs are met.”

The Sigonella hospital is the oldest of the three facilities, having opened its 22-bed, 98,000-square-foot facility in 1993. The hospital saw 40,000 outpatients last year and had 290 admissions last year, delivering 85 babies and admitting 115 patients for internal medicine and general surgery.

The 20-bed, $42 million hospital and dental clinic in Naples saw 69,400 outpatients in 2015 and had 456 admissions. It delivered 140 babies and admitted 196 patients for internal medicine and general surgery.

The hospital in Aviano, with 18 beds and 90,000 square feet, opened in 2006 with a $36 million price tag. A spokesman for U.S. Air Forces in Europe declined to give admissions statistics for the hospital, referring a reporter to the Department of Defense.

The downgradings follow the 2014 closure of a birthing center at the Army post in Vicenza, Italy, six years after it opened, a move described by military leaders as a cost-savings measure. Military families in Vicenza were referred to nearby Italian hospitals or to the Aviano base hospital, about 90 minutes away.

Language and cultural barriers make local hospitals an unattractive option to some Americans, while others are concerned about quality of care. Yet military use of local hospitals is hardly new, especially in Europe. Local providers work closely with the military, and many facilities seek to accommodate American clients.

In the Naples area, Clinica Mediterranea in Mergellina and Pineta Grande in Castel Volturno have added private rooms and staffed more English-speaking nurses to make Americans more comfortable.

beardsley.steven@stripes.com Twitter: @sjbeardsley


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