Evaluating the HCU (Health Care Unit) for Performance Monitoring and Resource Allocation Decisions Using Navy Ambulatory Care UCA (Uniform Chart of Accounts) Expense and Workload Data

摘要

In recent years, case-mix methodologies have been developed as a basic for measuring hospital performance and for identifying normative costs of providing care to homogenous groups of patients. Two notable efforts in this area that are relevant to the military have been the development of the Health Care Unit (HCU) and the work done in prior years at the Naval School of Health Sciences exploring the applicability of Diagnosis Related Groups (DRGs) to Navy hospital performance measurement. These efforts have demonstrated that incremental improvements are possible using currently available data. The work presented in this report has used the methodologies employed in these previous efforts as a foundation for exploring a means of measuring outpatient performance across all Navy medical facilities. The purpose of this study was threefold and focused on the following main objectives: 1) evaluating the validity of the HCU in measuring outpatient productivity in Navy facilities; 2) evaluating the utility of using three-digit Uniform Chart of Accounts (UCA) final account codes; and 3) exploring the ability of facility characteristic variables such as size, location, and mission to explain differences in performance across UCA reporting Navy units. Keywords: MHCS(Military Health Care System); Productivity.