Unwarranted Variation in the Medical Management of Injured Civilian Workers in the U.S. Army Medical Command

摘要

Variation exists within the U.S. Army Medical Command in the structures and processes used to medically manage injured civilian workers. Likewise, there is great variation in the average total cost per case. In order to establish an evidence base for best practice in the medical management of injured civilian federal employees, structure and process variables were obtained from an annual status report submitted from each Army medical treatment facility (MTF). Using hierarchical multiple linear regression, these variables were tested as potential predictors of the average total cost per case of an injured civilian employee in each MTF. Three variables were identified as statistically significant predictors that collectively accounted for 79% of the variance observed in the average total cost per case. The presence of an occupational health physician on the local workers' compensation oversight committee is a statistically significant predictor of the study outcome, uniquely accounting for 22.5% of the variance seen in the average total cost per case. Management implications, study limitations, and recommendations for future studies are discussed.