Improving Hospital Productivity: An Analysis of the Contribution of Administrative/Clerical Staff to Physician Productivity.

摘要

During the mid 1980s, Navy medicine was under constant criticism by its users, and members of Congress. Between FY85 and FY88, the number of outpatient visits decline 21 percent within Navy Medical Treatment Facilities (MTFs), while CHAMPUS outpatient visits increased 78 percent. During this same period, fleet operational assignments tripled and other programs were implemented that reduced Navy's ability to provide patient care in the U.S. In addition, between fiscal years 1980 through 1988, physician retention rates within Navy declined to 43 percent, lower than the rates for Army and Air Force. According to the GAO, one of the chief complaints of all military physicians is inadequate levels of administrative/clerical support. Thus, it has become increasingly important that Navy manpower requirements be determined with increased accuracy to maximize MTF productivity. This study uses regression analysis to evaluate the functional relationship between administrative staff mix and physician productivity across similar hospitals, focusing on workcenters in the primary care areas, where the need is greatest. Data used in this study is from the Medical Expense and Performance Reporting System (MEPRS). Unfortunately, when comparing hospitals the data appear to be inadequate for demonstrating a relationship between administrative/clerical staffing and physician productivity, although when comparing workcenters the results appear more promising.