A Methodology for Quantitative Evaluation of Health Care, with Application to Postsurgical Care in U.S. Air Force Hospitals

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Report Number: RM-6347-PR
Author(s): Eckles, J. E., Root, J. G.
Corporate Author(s): The RAND Coporation
Date of Publication: 1970-07
Contract: F44620-67-C-0045
DoD Task:
Identifier: AD0710199

Abstract:
This memorandum presents a methodology to assist in evaluating the quality of health care in a quantitative manner. The study is focused on the problem of evaluating the postsurgical care provided by 20 U. S. Air Force hospitals. These health-care delivery units are compared in terms of two quantitative measures--postsurgical length of patient stay in the hospital, and incidence of complications. In carrying out the comparisons, explicit attention is given to variation in patient characteristics from unit to unit so that the evaluative measures developed reflect the activities of the health-care delivery unit and not underlying differences in the patients. The results of the study indicate that there are large differences among the 20 Air Force hospitals studied--differences that cannot be accounted for by variation in patient mix or by statistical error. Thus the study pinpoints those hospitals that should be examined in order to determine what hospital characteristics, other than patient composition, influence the length of stay and incidence of complications. The analysis also suggests that fully one-fourth of all bed days of care given by Air Force hospitals are accounted for by convalescing active-duty personnel who but for reasons related to duty status would be discharged from hospital care.

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