A Statistical Analysis of the Relationship of Distance and Mode of Transportation on Length of Stay at Brooke Army Medical Center

This retrospective quantitative study examined the relationship of distance, measured based on catchment are status, and mode of transportation, measured based on the use of the U.S. Transportation Command's (TRANSCOM) aeromedical evacuation system, to determine their influence on length of hos...

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Bibliographic Details
Main Author: Hagen, John P
Format: Report
Language:English
Subjects:
AEROMEDICAL EVACUATION
ARMY FACILITIES
CHAMPUS
COST EFFECTIVENESS
DIAGNOSIS(MEDICINE)
DRG(DIAGNOSIS RELATED GROUP)
ECONOMIC ANALYSIS
Economics and Cost Analysis
HEALTH CARE FACILITIES
HEALTH CARE MANAGEMENT
LITERATURE SURVEYS
Medical Facilities, Equipment and Supplies
MEDICAL PERSONNEL
MEDICAL SERVICES
Medicine and Medical Research
MILITARY SURGEONS
RON(REMAIN OVERNIGHT)
SPECIALIZED TREATMENT SERVICE
SPINAL SURGERY
STATISTICAL ANALYSIS
THESES
TRANSPORTATION
UTILIZATION
UTILIZATION MANAGEMENT
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Summary:This retrospective quantitative study examined the relationship of distance, measured based on catchment are status, and mode of transportation, measured based on the use of the U.S. Transportation Command's (TRANSCOM) aeromedical evacuation system, to determine their influence on length of hospital stay at Brooke Army Medical Center in FY 1996 in order to better understand the irnpact these patients have on utilization management. Based on criteria driven selection of four discharge Diagnosis Related Groups (DRGs), patient records (n = 657) were selected for review. Based on statistical analysis, this study determined that increases in LOS for patients using the aeromedical evacuation system were statistically significant when compared to patients arriving at BAMC by other means. These results were expected. This study also determined that LOS for patients coming from outside the local catchinent area did not have statistically significant increases in LOS when compared to those from within the local catchrnent area. Based on the literature review and subjective observations, these results were not anticipated. This study recommends establishing a preadmission assessment process for all inpatient transfers coming to BAMC via the aeromedical evacuation system to determine the need for admission based on physician assessment. In addition, continued use of the Remain Overnight (RON) service as a means to reduce LOS in aeromedical evacuation patients is highly recommended. No recommendations for change were made regarding out-of-catchment area patient management. Based on the results of this study, out-of-catchinent area patients appear to have similar utilization patterns based on the LOS as patients from within the catchment area.