Comprehensive Clinical Evaluation: A Case Study of the Efficiency of Phase 2 and3 of Post Gulf War Illness Evaluations at Brooke Army Medical Center

摘要

This study examined the effects of the program change released in January 1995 onthe efficiency of the inpatient Comprehensive Clinical Evaluation Program, Phases II and III, at Brooke Army Medical Center between October 1994 and February 1995. Attention was focused on lengths of stay, numbers of consults, and average waiting times for consults. A random sample of Post Gulf War veterans who had completed the program were chosen. Group 1 consisted of 21 patients admitted prior to the program change; Group 2, a sample of 15, were admitted after. Pearson r correlations were used to measure the correlation between variables within the groups. The correlation between length of stay and number of consults for Groups 1 and 2 were 21 and 57 percent, respectively. Analysis-of-variance was used to compare differences between group means. Mean length of stay was significantly shorter and numbers of consults significantly fewer in Group 2. These findings support the argument that medical protocols have an adverse impact on physicians' ability to manage patients on a case-by-case basis, and may cause an increase in lengths of stay, numbers of consults, and hospital costs. These data may help providers and administrators plan clinical protocols focused on case management.