A Comparative Analysis of Emergency Room Utilization Before and After TRICARE Implementation at Reynolds Army Community Hospital Fort Sill, Oklahoma.
Final rept. Jul 95-Aug 96,
ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATI ON
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The DoD managed care initiative, TRICARE, brings with it many changes as it becomes fully implemented. This retrospective study examined the effect of TRICARE on emergency room ER utilization at a 116-bed Army medical treatment facility MTF which operates a Level II ER. Two convenience samples of patient records were examined. One sample, the pre-TRICARE group n518, consisted of patients using the ER during a nine-day period in 1995 while the other sample, the post-TRICARE group n410, consisted of patients using the ER during a comparable nine-day period in 1996. The results demonstrate that ER utilization varied as a function of TRICARE with a 20.8 percent decrease in patient volume and a 27.7 percent drop in nonurgent use. Thirteen categorical variables were extracted from ER records and further sub-categorized into 59 study variables. THe groups were compared, variable by variable, for any differences using a students t-test. A total of eleven sub-category variables were statistically signifcant at the p .05 level. Stepwise multiple regression analysis yielded an R-square of .23 for each group in analyzing nonurgent use.
- Medicine and Medical Research
- Medical Facilities, Equipment and Supplies