Perceptions of the Public

1

• Perceptions of the Public
• About Military Health Care

2
Background and Objectives

• With the current conflict in Iraq, the military
  healthcare system (MHS) has been in the public
  eye
• Few data are available, however, about the
  publics perception of the MHS
• TMA recently conducted focus groups
• To ascertain the publics perceptions of the MHS
• To understand the basis for these perceptions

3
Method

• Acquired OMB clearance
• Conducted seven focus groups
• Denver CO, Philadelphia, PA, Alexandria, VA
• 66 participants
• Average age 45
• Gender 51 male 49 female
• Education 3 less than HS 11 HS 43 some
  college
• 29 college 14 graduate school
• Race-Ethnicity 62 white, 27 African Am., 9
  Hispanic, 3 other
• Conducted groups at focus group facilities
• Collected the data in January 2008

4
Moderation Method

• Most questions were used as prompts for
  discussion and participants responded if they had
  something to say.
• Posed a few round-robin questions in which all
  participants were asked to respond.
• When you think about the military healthcare
  system, what is the first thing that comes to
  mind?
• If you had to summarize, in a sentence, how you
  feel about the care provided by the military
  healthcare system what would your sentence be?

5
Results

• Participants overall knowledge of MHS
• Views on quality of care provided by the MHS
• Comparing the perception of the quality of care
  provided by the MHS versus the civilian
  healthcare system

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Questions Knowledge of the MHS

• What do you think of the MHS? Of the VA?
• How are they alike, how are they different?
• Where do you get your information about the MHS?
• How much have you read, seen, or heard about the
  MHS in the last 12 months?
• What topics or stories do you remember reading
  about, seeing, or hearing?

7
Results Knowledge of the MHS

• Virtually all non-DC area participants felt they
  had little or no knowledge of the MHS
• In contrast, those living in the DC area were
  familiar with the MHS
• When youre serving, you get care from the MHS.
  When youre out, you go to the VA.
• Overall participants views were mostly based on
  the experiences of family, friends, and
  acquaintances and TV news
• Some of the basis for their views dated back to
  Vietnam and WWII experiences

8
Results Knowledge of the MHS

• Nearly all participants were unaware that the MHS
  and the VA were two different health systems
• Perceptions of the MHS are inextricably
  intertwined with views about the VA it is all
  the government
• Perceptions of the longer term care provided to
  returning veterans, and thus the VA, is poor
• At times during the sessions, participants needed
  to be reminded to focus on MHS and not the VA
• Most could not speak with confidence about the
  quality of specific MHS services, such as
  physical rehabilitation, mental health
  counseling, or drug and alcohol counseling
• When asked what they had heard about the MHS in
  the last 12 months, most said nothing or very
  little
• In contrast, several DC-area participants
  mentioned Walter Reed

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QuestionsQuality of Care

• How would you describe the quality of care the
  military provides to AD service members? To
  retirees and their families, etc?
• For example, would you use words like excellent,
  good, fair, poor or something else?
• How would you describe the quality of inpatient
  care at military hospitals? Physical
  rehabilitation, mental health, etc.?
• For example, would you use words like excellent,
  good, fair, poor or something else?
• Of the services discussed, which do you think is
  the militarys strength? Which is its weakest
  area?

10
Results Perception of the Quality of Care

• Across all focus groups, the perception of the
  care provided by MHS are mixed
• Some high praise but also some negative
  impressions
• Often unsure of the quality of care but strongly
  believe military personnel deserve the very best

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Results Positive Views on Quality of Care

• All praise the comprehensiveness of the benefits
• They get a full package in the service they
  get all the care for free.
• Some praise for the system and care provided
• We have employees (e.g., military family
  members) who choose the militarys healthcare
  benefit over our organizations health plan. In
  that respect, it says a lot about the military
  heath care.
• My best friend who lost a leg in Iraq got
  excellent care at a military hospital.

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Results Negative Views on Quality of Care

• There are some negative impressions
• You have to go where they say its a
  government program
• I think its probably like with other health
  providers you can get better care if you
  know how to work the system.
• Most participants recalled news media reports
  about specific problems and their negative
  impressions of those were very strong.
• What I heard about Walter Reed Hospital was
  shocking. I couldnt believe it could be so
  bad.
• It was dirty there were rats it was
  disgusting.

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Results Quality of Care Strengths and Weaknesses

• Participants views on the strengths of the MHS
• Most participants believed that the quality of
  physical care is a strength area
• Theres so much high tech stuff they can do
  now to replace limbs, like give someone a
  whole new leg.
• Participants views on the weaknesses of the MHS
• Most participants viewed mental health and
  substance abuse services as weak areas
• There are people on the streets with mental
  health problems and addictions. They
  needed help from the government and they
  didnt get it.

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QuestionsComparing the MHS to Civilian
Healthcare

• In general, how does healthcare for the military
  community compare with healthcare for people not
  in the military?
• Would you say it is much better, somewhat better,
  etc?
• How would describe the quality of healthcare you
  have received in the past 12 month?
• Excellent, good, fair, etc?
• When comparing to your own care, how does the
  quality of care that you receive compare to the
  care the military system provides?
• Would you say it is much better, somewhat better,
  etc?

15
Results Comparisons of the MHS vs. Civilian
Healthcare

• Compared to the civilian sector, military
  healthcare was thought to be of the same quality
  
• Dont separate quality of care from coverage and
  choice
• Most participants believed MHS offers less choice
• Most participants believed MHS care was more
  comprehensive and entailed no out-of-pocket
  expense
• Most participants thought the quality of care for
  active duty members was better than for retirees
• They care more about people who are actually
  serving. After that, youre forgotten ... not as
  important.

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Summary

• The general public views the MHS and the VA as
  the same healthcare system
• Perceptions of the quality of care that the MHS
  provides are mixed
• Equally balanced between good and bad
• The public does not feel very knowledgeable about
  the specific types of care (e.g. substance abuse
  counseling)
• Most of their information about the MHS comes
  from the experiences of friends and acquaintances
  rather than the media

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QUESTIONS?????