Hospital stay is in there. Check your pilot settings in workshop re dead is dead etc. If you play dead is dead CFS3 will report you dead a lot more often no chance of hospital. Just the way it is.
If you choose "Easy" then OFF will give you a chance to survive more often try that if you have not.
Put Weather mode on AI weather Gen, and then you can choose light "Campaign Mission Frequency" 1 mission a day normally. You can also put it on manual/auto advance, and skip a few days missions if you like to account for leave etc.
It's been noted previously AI should break off more (runaway is already in there and they often do actually, but usually in a way that gets them killed like fly level and head for home). For some fewer encounters, lasting less time may be duller, so it again would somehow need scalability somewhere, something we'll look at if possible.
A sim is unrealistic before you even start, you have many lives, in real life you have of course only one. So many players would engage a lot less in real life. Many factors at play, and as always - we look into things best we can and will do the best we can.