Variation in Civilian Healthcare Utilization Amoung Active Duty Army Service Members in Germany

摘要

A review of the literature indicated that both military and civilian medical systems struggle to provide the greatest health benefit at the lowest cost. This struggle is particularly challenging as a result of the military drawdown in Europe since medical resources have been reduced faster than the decrease in the beneficiary population. As a result of this imbalance between resources and customers, many beneficiaries may seek their care outside the military system. A first step toward managing access and health care cost is an analysis of the historical utilization rates. This study examined the variation of civilian health care usage among the eleven health clinics within one medical facility's geographic area in Europe. The data consisted of a two-year (Fiscal Year(FY) 97 - 98)retrospective review of the number of Army active duty claims and associated cost for civilian health care. An analysis of proportions from unordered categories yielded significant (a =0.01) variation in both years for both health care cost and claims. A paired sample t-test yielded significant (a = 0.05)differences in the means of both the claims and cost between FY97 and FY 98. Possible sources of this variance may be the wide dispersion of the clinics, deployment induced access difficulty and distance to tertiary care.