Survey Gauges Satisfaction with Military Health Care

Some 75,000 surveys mailed in January to people who recently had completed health care appointments at one of some 2,100 clinics in military treatment facilities nationwide revealed higher satisfaction rates than those recorded for civilian patients visiting civilian physicians. Those surveyed included service members, military spouses and parents of children who completed appointments.

The 17-question survey gauged satisfaction levels for medical care, access, quality of care and interpersonal relationships. Respondents said interpersonal relationships -- the amount of time their doctor spent with them, attention to their needs and the friendliness and courteousness of the staff –- were the best aspects of their appointment.

The same survey is mailed monthly, 30 to 50 days after an appointment, to randomly selected patients. Besides answering the questions, respondents can add comments on a separate sheet of paper. Nobody surveyed is identified in any report or release of survey information.

Defense health officials will use this information to raise the quality of health care provided under the DoD tri-service health care program, TRICARE, to a standard level systemwide. Military treatment facilities will receive data from the survey they can use to measure their program against other clinics and make improvements.

"We want to know how people view their experience, and [through this survey] we're letting customers know we really care about them," said Gwen Brown, deputy assistant secretary of defense for health budgets and programs. "We want to know what they think of the treatment they received, their provider and the facility. We need this information to improve the system.

"Based on data we have so far, the survey is going to have an immediate impact," Brown said. "If a military treatment facility sees [from the information the survey provides] that they're at the low end of averages for the level of care they're providing, they're going to want to act quickly to rectify their deficiencies."

For each particpating clinic, about 35 outpatients a month will get surveys, explained Bob Opsut, director of program review and evaluation for DoD health affairs. Opsut, whose office administers the survey, said he's aware people may get tired of completing surveys they receive from health and other DoD agencies as well as from commercial and private sources. "But if we want feedback, we have to survey our customers," he said.

"We don't want to bombard our customers with requests for information, so we've purposely made this survey short and specific. They can finish the survey in less than 10 minutes," Brown added.

Health officials were slightly surprised with results from the January survey. "We benchmark satisfaction levels at military treatment facilities with those in civilian health maintenance organizations, and we were surprised when the survey showed our overall patient satisfaction to be higher than the national norm," Brown said.

"The results from the January survey told us what customers are saying we're doing right, and we're very encouraged by that," she said. "That doesn't mean our patients are totally satisfied in all areas across the spectrum of TRICARE services. For example, access continues to be a problem systemwide. TRICARE sets specific requirements for the length of time between when a person calls for an appointment and actually sees a provider. Not every clinic is meeting those standards.

"We want to know how the facilities in the low end of the scale rate six months or a year from now, and the survey will provide us that data."

Although data from the initial survey in January took several months to compile and analyze, Opsut said data from subsequent surveys should arrive at military treatment facilities within 70 days. Facilities will receive monthly reports based on the previous three months of data, from which to measure their health care proficiency.

"One of our top priorities in military health care today is to focus on those things that will cause our patients to want to choose military medicine," said Dr. Ed Martin, acting assistant secretary of defense for health affairs. "To do that, we must know what our beneficiaries think about their health care; from the details of a specific visit to the more general perspective of how the system is responding to their needs. We need to hear what we are doing well and what needs improvement."

Under contract to DoD, United Healthcare and its subcontractor, National Research Corp., conduct the surveys. Civilian comparisons come from annual interviews National Research Corp. conducts with 130,000 enrollees in health maintenance organizations.