A Comparative Analysis of Emergency Room Utilization Before and After TRICARE Implementation at Reynolds Army Community Hospital Fort Sill, Oklahoma.

Abstract

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 (n=518), consisted of patients using the ER during a nine-day period in 1995 while the other sample, the post-TRICARE group (n=410), 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 student's 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.

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Document Details

Document Type
Technical Report
Publication Date
May 01, 1996
Accession Number
ADA324269

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  • James M. Gamerl

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  • Academy of Health Sciences

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