Variation in Quarters Dispositions A Force Protection and Readiness Issue Explanations and Control Method

摘要

This paper attempts to quantify the extent and magnitude of the portions of variation linked to the provider's behavior, population characteristics and nonhealth factors. A method to monitor and control for unnatural variation is detailed using a control chart system. A retrospective analysis of a year's worth of data for 12 medical facilities was conducted using a Chi-Square method, adjusted by a Multiple Admission Factor, to test the overall hypothesis that there is a variance in quarters rates among medical facilities. A correlation analysis and multiple regression model were conducted using the quarters rate as the dependent variable and demographic data as independent variables was used to examine the relationship between a MTF's quarters utilization rate and demographic factors. There is a greater than threefold variation among the 12 medical facilities under study. The strongest nonhealth factor impacting the quarters rate was if the medical facility had beds or not. Indicating a supply side driver in use of hospital beds, available beds are used rather than sending patients to quarters. Other significant factors include beds per thousand and percentage of population that are black. Statistical control charts used to monitor facility quarters rates will aid in the monitoring of over/under utilization and further aid in the early identification of negative health trends. Additionally, a 10% change in quarters use will save 830 admissions and regain 913 2,740 lost duty days.