Evaluation of Ambulatory Care Classification Systems for the Military Health Care System
ARMY HEALTH CARE STUDIES AND CLINICAL INVESTIGATION ACTIVITY FORT SAM HOUSTON TX
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This report discusses the evaluation of ambulatory patient classification systems for military use. The two systems which appeared to have the greatest potential for this purpose were the Products of Ambulatory Care PACs which was developed by the New York State Health Department and the Ambulatory Visit Groups AVGs which was formulated by a group at Yale University. The data base used for all evaluations consists of a sample derived from the Armys Ambulatory Care Data Base ACDB Study. The sample used in the evaluation contained 516,006 clinic visits. Because the military does not have a per visit cost accounting system, four costing methodologies were applied to the PACs and AVGs to allow analyses on the effectiveness of these groups as resource allocation devices. An important finding was that the effectiveness of a classification system is directly related to the methodology used to attach a cost to each visit. the results of the study also provided a greater understanding of ambulatory classification systems when using a large data set which covered the spectrum of military-based hospital out-patient services. Even with the large data set, all the AVGs were not used 140 empty groups. Conversely, given the large number of visits and the diversity of these visits in each of the PACs, it seems appropriate to expand the PAC grouping beyond the present configuration.
- Medicine and Medical Research