The Demand For Military Health Care
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The Demand For Military Health Care
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Author : Susan D. Hosek
language : en
Publisher: RAND Corporation
Release Date : 1995
The Demand For Military Health Care written by Susan D. Hosek and has been published by RAND Corporation this book supported file pdf, txt, epub, kindle and other format this book has been release on 1995 with Medical categories.
For a number of reasons, military beneficiaries--active-duty service members, military retirees, and their dependents--are heavier users of medical care than are comparable civilian populations. These services are currently provided by military treatment facilities (MTFs) or the civilian medical facilities, the latter through the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). However, over the past several years, the system has faced the twin challenges of downsizing in consonance with the rest of the Department of Defense and of controlling escalating health care costs. While care provided in the civilian sector can be more expensive than that provided in the MTFs, the free care available in MTFs sparks greater demand. Moreover, the MTF system was designed to meet wartime, rather than peacetime needs. In weighing the pros and cons of various alternatives, this report suggests that beneficiaries might prefer civilian health plans, as long as there is no erosion of benefits in making such a shift.
The Demand For Military Health Care Supporting Research For A Comprehensive Study Of The Military Health Care System
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Author :
language : en
Publisher:
Release Date : 1995
The Demand For Military Health Care Supporting Research For A Comprehensive Study Of The Military Health Care System written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1995 with categories.
The Military Health Services System (MHSS) provides health care to active-duty service members, military retirees, and their dependents. Over the past several years, the system has faced the twin challenges of downsizing in consonance with the rest of the Department of Defense (DoD) and of controlling escalating health care costs. These challenges cannot, however, be dealt with independently. Closing military treatment facilities (MITs) could drive non- active-duty beneficiaries to seek more expensive medical care from the civilian sector, care that is reimbursed by DoD through the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). In 1991, in response to a congressional request, the Director of Program Analysis and Evaluation (PA & E) undertook an evaluation of health care utilization and costs within the current system and of various possible alternatives to that system. PA & E turned to RAND's National Defense Research Institute (NDRl) for analytic support in responding to Congress. Specifically, we were asked to compare current utilization by military beneficiaries with use by civilians, to develop analytic cases to study alternatives to the current medical structure, and to assess costs and changes in utilization associated with these cases (with the exception of MIF costs, which are being assessed by the Institute for Defense Analyses). pg10. JMD.
The Elasticity Of Demand For Health Care
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Author : Jeanne S. Ringel
language : en
Publisher: Rand Corporation
Release Date : 2002
The Elasticity Of Demand For Health Care written by Jeanne S. Ringel and has been published by Rand Corporation this book supported file pdf, txt, epub, kindle and other format this book has been release on 2002 with History categories.
Provides a framework for understanding the effects of changes in the Military Health System benefit structure on the demand for health care services paid for by the DoD.
The Elasticity Of Demand For Health Care A Review Of The Literature And Its Application To The Military Health System
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Author :
language : en
Publisher:
Release Date : 2002
The Elasticity Of Demand For Health Care A Review Of The Literature And Its Application To The Military Health System written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2002 with categories.
Understanding the effects of changes in health insurance policies on the demand for health care services is an important and timely topic. As the Military Health System (MHS) has evolved over time, it has begun to adopt cost-containment strategies that have been tested in private health plans. These strategies have led to changes in many aspects of the health care services offered to Department of Defense (DoD) beneficiaries. Each change potentially can affect the number of people accessing services, the intensity of use, and the cost to the DoD. The goal of this report is to summarize the research relevant for considering the effects of policy changes on the demand for DoD health care services and associated costs.
Universal Health Care
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Author : United States. General Accounting Office
language : en
Publisher:
Release Date : 1994
Universal Health Care written by United States. General Accounting Office and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1994 with Armed Forces categories.
Multiple Criteria Decision Engineering To Support Management In Military Healthcare And Logistics Operations
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Author : Nathaniel Bastian
language : en
Publisher:
Release Date : 2015
Multiple Criteria Decision Engineering To Support Management In Military Healthcare And Logistics Operations written by Nathaniel Bastian and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015 with categories.
The U.S. Department of Defense Military Health System (MHS) is a unique health system in that it recruits and trains its own medical staff, has a generally physically fit patient population, and is a closed, single-payer system. The unique mission of the MHS comes with its own set of healthcare and logistics challenges above and beyond those of a civilian US-based health system. At the surface, the MHS is charged with delivering quality healthcare to a diverse population. At the core, however, that charge includes maintaining peacetime healthcare delivery capacity while ensuring the deployment readiness of the active force, and deploying, establishing and running forward deployed healthcare facilities to provide the necessary health services support for combat, stability, peacekeeping, and humanitarian assistance operations. Further complicating the delivery of quality care is the transient nature of healthcare providers either due to deployments or routine personnel moves between hospitals, clinics, and field units. Due to the complexity of the MHS, effective management of healthcare resources and logistics is paramount. This is also important to senior military leaders since many real-world decision problems in the MHS exhibit the presence of multiple, conflicting objectives for judging alternatives, as well as the need for making compromises or trade-offs regarding the outcomes of alternate courses of action. Further, most of these same resource allocation decision problems are faced under inherent, underlying uncertainties. As a result of these challenges, this doctoral dissertation employs methods of multiple criteria decision engineering to assist strategic decision-making and to support the complex planning and management of military healthcare resources, personnel, logistics, and financial incentives. The primary motivation is the requirement to provide data-driven, managerial decision support for decision problems in: 1) resource allocation and performance within the military hospital network, 2) military medical workforce planning and future force structure, 3) supply chain network design for humanitarian assistance and disaster relief aerial delivery operations, and 4) effectiveness of healthcare financial incentives on hospital efficiency. Multi-criteria and stochastic optimization models that leverage mixed-integer programming, Monte Carlo simulation, discrete event simulation, text mining, clustering analysis, regression modeling and econometrics are developed to provide critical insights for military decision-makers. The multiple criteria decision engineering methods in this dissertation are applied to several real-world decision problems within military healthcare and logistics operations to illustrate the impact and relevance of the results. First, we proffer the Multi-Objective Auto-Optimization Model (MAOM) -- a resource allocation-based optimization model that adjusts resources (system inputs) automatically -- which provides decision-makers with a decision-support tool for re-allocating resources in large health systems that are centrally controlled and funded, such as the MHS. The necessity to efficiently balance and re-allocate system resources among hospitals in a hospital network is paramount, especially as health systems experience increasing demand and costs for health services. In these systems, inputs are fixed at certain levels and may only be adjusted within medical treatment facilities, while outputs must be maintained. Second, we proffer the Objective Force Model (OFM), a deterministic, mixed-integer linear weighted goal programming model to optimize workforce planning for the U.S. Army Medical Department (AMEDD) Personnel Proponency Directorate (APPD). We also develop two stochastic variants of the linear OFM, which incorporate probabilistic components associated with uncertain officer continuation rates. We employ a discrete event simulation model to verify and validate the results. These models allow for better transparency of personnel for both the senior AMEDD decision-makers and the health services human resource planners at APPD, while effectively projecting the manpower structure that provides the appropriate skill levels (by grade) to meet the demands of the current workforce structure. Third, we develop a multiple criteria decision analysis (MCDA) framework to optimize the military humanitarian assistance/disaster relief (HA/DR) aerial delivery supply chain network under uncertainty. The model uses stochastic, mixed-integer, weighted goal programming to optimize network design, logistics costs, staging locations, procurement amounts, and inventory levels. The MCDA framework enables decision-makers to explore the trade-offs between military HA/DR aerial delivery supply chain efficiency and responsiveness, while optimizing across a wide range of real-world, probabilistic scenarios to account for the inherent uncertainty in the location of global humanitarian disasters, as well as the amount of demand to be met. Fourth, we propose the Fuzzy Multi-Objective Auto-Optimization Model (FMAOM), an optimization model with fuzzy constraints that can be used for automatic resource re-allocation with respect to different levels of risk preferences. The efficient use of resources in health systems is crucial mostly due to the increasing demand and limited funding. The implications of the proposed fuzzy decision-making model for healthcare decision-makers and its relevance to healthcare policy and management are discussed. Fifth, we measure the effect of a monetary incentive model on hospital efficiency and outcomes. The Army component of the MHS implemented a pay-for-performance financial incentive program in 2007 in an effort to stimulate patient quality, access, and satisfaction improvements. Using a retrospective, quasi-experimental design, the empirical analysis incorporates data envelopment analysis (DEA) with time windows and difference-in-differences estimation. Hospitals are evaluated in the U.S. Army, Air Force, and Navy during the period of 2001--2012. The results indicate a statistically significant reduction in efficiency for the hospitals that received financial incentives. The health policy implications of this study are applicable in light of the national healthcare debate and may assist healthcare policy-makers in determining the efficacy and associated trade-offs of pay-for-performance financing models. Last, we introduce the Stochastic Multi-Objective Auto-Optimization Model (SMAOM) for resource allocation decision-making under uncertainty in the MHS. The model can automatically identify where to re-allocate system input resources at the hospital level in order to optimize overall system performance, while considering uncertainty in the model parameters. The usefulness of the proposed model is illustrated by a computational experiment in which a traditional DEA model is compared to the proposed SMAOM for 128 hospitals in the three services (Air Force, Navy, Army) in the MHS using hospital-level data from 2009 - 2013. The application of SMAOM to the MHS increases the expected system-wide technical efficiency by 18% over the DEA model while also accounting for uncertainty of health system inputs and outputs. In summary, the multiple criteria decision engineering models described in this dissertation focus on supporting the management of scarce military health system resources, military workforce planning and force structure, military humanitarian logistics network design, and military healthcare financial incentives. The challenge, however, remains in careful and continual coordination with senior MHS decision-makers and hospital managers so that models proffered here are used effectively as decision support tools.
Military Personnel
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Author : Brenda S. Farrell
language : en
Publisher: DIANE Publishing
Release Date : 2011
Military Personnel written by Brenda S. Farrell and has been published by DIANE Publishing this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011 with Law categories.
This is a print on demand edition of a hard to find publication. Military medical personnel, who are essential to maintaining one of the largest and most complex health systems in the nation, are in great demand due to the need to treat injured or ill servicemembers, and advances in technology that require specialized personnel. To determine how well the Department of Defense and the services are developing their medical and dental personnel requirements, this report evaluated: (1) the extent to which the services have incorporated cross-service collaboration in their medical personnel requirement processes; and (2) the service-specific processes for determining their requirements for military and civilian medical personnel. Includes recommendations. Charts and tables.
Returning Home From Iraq And Afghanistan
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Author : Institute of Medicine
language : en
Publisher: National Academies Press
Release Date : 2010-03-31
Returning Home From Iraq And Afghanistan written by Institute of Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010-03-31 with Medical categories.
Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.
Evaluation Of The Department Of Veterans Affairs Mental Health Services
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Author : National Academies of Sciences, Engineering, and Medicine
language : en
Publisher: National Academies Press
Release Date : 2018-03-29
Evaluation Of The Department Of Veterans Affairs Mental Health Services written by National Academies of Sciences, Engineering, and Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-03-29 with Medical categories.
Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.
Population Health And Optimization Of The Military Health System
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Author : Beverly A. Pritchett
language : en
Publisher:
Release Date : 2001
Population Health And Optimization Of The Military Health System written by Beverly A. Pritchett and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2001 with Health services administration categories.
The military health system (MHS) is evolving at a rapid pace as a result of a variety of extraordinary pressures that are influencing the delivery of health care today. These pressures include the shortfall in health care funding in the Program Objective Memorandum (POM) for fiscal years 2002 through 2007. In addition, the Floyd D. Spence National Defense Authorization Act for fiscal year 2001 authorized an unprecedented expansion of benefits that exacerbates the funding shortfall. Lastly, the leaders of the MHS are fully aware that they have a requirement to remain accountable to Department of Defense, the line leadership and its beneficiaries. In order to be able to respond to pressures such as these, the Military Health System Optimization Team was created by the Assistant Secretary of Defense (Health Affairs). The team's mission is to develop a health services delivery system within an executable funding program. The team's focus is to reengineer the military health system from one that provides interventional care once a disease process has begun, to one that focuses on health promotion and disease prevention. The end result is improved health of the MHS population. The effort to improve population health will help to reduce demand on the system, thereby opening opportunities to recapture workload that had been shifted to contractors. The shift from purchased health care to health care provided within military treatment facilities will reduce the overall cost of operating the MHS. As the concept of improving population health through the monitoring of health status becomes the focus of the military health care system, the importance of integrating and analyzing data on health status becomes critical. The rationale is that information systems that provide status on the health of the population allow for the MHS to move from interventional health care to prevention services. Individuals at high risk for adverse health outcomes can identified.