The Department of Defense released today results from its
comprehensive survey designed to learn how beneficiaries view
their health care. During the spring of 1995, the survey queried
over 160,000 active duty personnel, retirees, family members and
survivors on such issues as their access to health care,
satisfaction with military and civilian providers, their health
status, and their use of health care and preventive services.
Individuals were selected at random to participate in the survey.
About 54 percent returned their questionnaires. The data has
been weighted so that the findings are representative of all
beneficiaries.
This survey solidly reinforces our determination to pursue
TRICARE (DoD's managed health care program), which is designed to
facilitate access to care at all levels of the medical continuum.
Access to military health care is our Number One problem, said
Dr. Stephen C. Joseph, assistant secretary of Defense for Health
Affairs.
Results showed that the majority of beneficiaries (58
percent) rely on military facilities for their care. This figure
ranged from 92 percent of active duty personnel to 35 percent of
retirees age 65 and over.
Overall, three-quarters of military beneficiaries reported
that they made at least one outpatient visit in the previous 12
months, while 12.5 percent said they had spent at least one night
in the hospital during the same period. Regarding satisfaction,
those who used military facilities rated it as 3.4 on a scale of
1 to 5, five being excellent. Beneficiaries expressed higher
satisfaction with quality of care than with access to care.
Joseph remarked that It is interesting that members of
retiree households gave higher ratings than members of active
duty households for all aspects of care surveyed. It may reflect
differences in age, and satisfaction generally increases with
age. Joseph went on to point out that the active duty felt
most satisfied with financial aspects of their care, including
protection from financial hardship, while retirees under age 65
were most satisfied with the quality of their care.
Queries about access to health care included whether
beneficiaries have a regular source of care; travel time to their
health care facility; and how many days or weeks they must wait
for an appointment. The survey found that over 95 percent have a
place where they usually go for health care.
Of the active duty members using a military facility for
health care, about 88 percent reported travel time under 30
minutes. Among non-active duty beneficiaries the number ranged
from 88 percent for active duty family members to 64 percent for
retirees over the age of 65.
Only about 45 percent of active duty and their family
members reported that they waited one week or less for a
scheduled appointment. For other types of beneficiaries, only 33
to 38 percent had the same experience.
Survey results will be used by both DoD policy makers and
local medical facility commanders to identify ways to improve the
delivery of care to military beneficiaries. DoD will conduct
similar surveys annually. The data will become more valuable
when the Department builds up a number of years of experience
with the survey. With several iterations, analysts will be able
to examine both the current state of health care and trends for
key variables, stated Joseph.
The 1996 survey effort has begun and includes questions
about TRICARE, DoD's managed health care program, which is
designed to improve access to care as well as to maintain high
quality and control costs. The survey will be one of the tools
used to assess changes in health care delivery under TRICARE;
however, TRICARE will not be fully implemented nationwide until
FY 1997.
The Defense Manpower Data Center provided technical support
and contractual assistance to Health Affairs through all stages
of the survey. Representatives from each Service branch
participated in the development of the survey.
