Financial Analysis of the Patient Access and Advice Line. An Instrument of Demand Management at the USA Medical Department Activity- Heidelberg

摘要

The concept of managed health care was developed in the 1930s in an effort to provide affordable health care. Managed care came to dominate the healthcare landscape by promising to reduce the astronomical rise in healthcare costs experienced in the 1980s. Demand management has become one of the tools managed care companies propose to use to sustain the cost cutting potential of managed care. One key component of demand management is nurse assessment and advice offered by telephone, formerly called a 'nurse advice line' or 'telephone triage'. Demand management systems integrate Primary Care Managers, prevention and wellness programs, self-care instruction, and telephone advice and triage. A call center, typically staffed with Registered Nurses, acts as the focal point for access to the health care system in a mature managed care environment. With the start of TRICARE-Europe and the cessation of the CHAMPUS demonstration project on 1 October 1997, the military health care system in Europe entered a managed health care environment for the first time. This change has required every health care facility in Europe to evaluate how it is doing business to ensure that every dollar spent contributes to meeting the health care needs of its patient population. This project provides a financial analysis of the Patient Access and Advice Line currently in operation at the U.S. Army Medical Department Activity in Heidelberg Germany. This paper describes the cost to implement and run the current system, and evaluates the expected cost savings and benefits. It answers the question, 'Are the benefits of the PAAL worth the costs'.