DoD Military Health System Beneficiary Survey Program General HealthOBGYN - PowerPoint PPT Presentation
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DoD Military Health System Beneficiary Survey Program General HealthOBGYN
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... areas for improvement; benchmark; focus on medical/surgical/OB care. DoD is a benchmark in medical / surgical care. 2003 HCSDB Results: Access / Wait Times ... – PowerPoint PPT presentation
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Title: DoD Military Health System Beneficiary Survey Program General HealthOBGYN
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DoD Military Health System Beneficiary Survey
ProgramGeneral Health/OB-GYN
- Briefing for DACOWITS MAY 25, 2004
- Ms. Patricia Collins, TMA, Office of the Chief
Medical Officer - Lt Col Mike Hartzell, USAF, OASD(HA)/TMA Health
Program Analysis Evaluation Directorate - CAPT Katherine Surman, NC,USN, OASD(HA) Clinical
Program and Policy
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Health Care Survey of DoD Beneficiaires
(HCSDB)-Event Based Beneficiary Survey
- Assess beneficiary experiences with specific
encounters - Primarily measure customer service at time of
specific visit. - Based on sample of encounters.
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Health Care Survey of DoD Beneficiaries
- Mail/Web survey measuring beneficiary
satisfaction with all healthcare delivery for
previous 12 months. - Administered annually since 1995.
- Size 50,000 questionnaires quarterly.
- Uses inform Health Affairs (HA) and TRICARE
(TMA) leadership. Identify areas for improvement
benchmark against civilian facilities.
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Outpatient Customer Satisfaction Survey
- Measure patient satisfaction with specific
outpatient Military Treatment Facility (MTF)
encounter. - Administered quarterly ongoing since 1998.
- Size 19,000 4,500 telephone 4,500 web
surveys. - Uses inform HA/TMA leadership identify areas
for improvement benchmark.
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Inpatient Customer Satisfaction Survey
- Measures satisfaction with inpatient care at MTFs
and purchased care. - Conducted annually since 1998.
- Size 30,000 MTF/15,000 purchased care.
- Uses inform HA/TMA leadership identify areas
for improvement benchmark focus on
medical/surgical/OB care. - DoD is a benchmark in medical / surgical care.
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2003 HCSDB ResultsAccess / Wait Times
- Health plan ratings for all TRICARE enrollment
groups have increased from levels in 2001. - Active duty have the lowest health plan and
getting healthcare access ratings. - MTF users are no more likely than users of
civilian or VA facilities to report long waits in
doctors offices, but are more likely to report
long waits for appointments and that their
doctors visits are too short.
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2003 HCSDB ResultsContinuity/Care/Service
- Most active duty Prime enrollees do not have a
personal doctor or nurse, nor do one-third of
non-active duty enrollees. - Breast and cervical cancer screening rates of
both active duty women and dependents of active
duty exceed Healthy People 2010 goals, but rates
of first trimester pregnancy care fall short of
the national benchmark. - Since 1999, the proportion of TRICARE users who
report that claims handling is correct and timely
has gone up every year.
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OB/GYN Care Facts
- Childbirth is the primary reason for
hospitalization in the United States and in the
Military Health System (MHS). It accounts for 40
of the health care in the MHS. - Obstetrical care is often the first experience a
family member has with the military health care.
Impressions of these encounters can affect health
care decisions following childbirth. - National Defense Authorization Act for 2002
created the opportunity for TRICARE Standard
patients to obtain obstetric without a
non-availability statement from a military
hospital. This was effective December 28, 2003.
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Standards for OB/GYN Care
- Prior studies have shown that OB/GYN customer
service has lagged behind the civilian sector. - The Family Centered Care Policy which was enacted
in January, 2004 is focused on improving early
intervention and continuity of obstetrical care
by offering comprehensive coordinated service. - Little data at present due to recent start.
Ancedotal evidence is available regarding MTFs
that have started and/or enhanced their programs.
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Partial List of New Standards
- Continuity of Care with the same provider/small
group no fewer than 75 of routine visits. - Follow-on appointments available prior to leaving
clinic. - DoD/VA Clinical Practice Guidelines for
uncomplicated pregnancies. - Steamlined DEERS Registration for the newborn.
- 24/7 Lactation Support.
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Civilian Comparison Data
- National Perinatal Information Center (NPIC)
contract for 2002 data. Compared 22 MTFs with OB
services to comparable civilian facilities
regarding case mix and outcomes. Study to be
repeated in 2004. - Preliminary results show that these MTFs are very
similar in types of OB patients seen and the
outcome of care.
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Civilian-Military Studies
- Medical Team Training Combined study of 15
military and civilian hospital Labor and Delivery
Units to study how teamwork among staff may
reduces errors and affect outcomes. Based on
model utilized at Beth Israel Deaconess Medical
Center (Boston, MA). - Results pending summer, 2004.
- Concepts can be used in other hospital settings,
e.g. Operating Suites, Intensive Care, etc.
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Summary
- Be the provider of choice for our military
families. - Recognize where we must do better.
- Examine not only our perinatal care, but other
types of care for quality processes,
effectiveness and results. - Continue with surveys, research and trying new
things! - Share successful approaches to care such as group
prenatal support visits, Daddy Bootcamp and
recapturing neonate intensive care patients.
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