Ray M A, Turkel M C
Florida Atlantic University, College of Nursing, Boca Raton, FL 33431, USA.
Mil Med. 2001 Apr;166(4):281-9.
Mission readiness is dependent on a healthy total force and the response of military medical and nursing services. Managed care has become the norm in U.S. health care, including the Department of Defense Military Health System. Cost management, health maintenance organizations, and other health plans are defined as "managed care," an aggressive cost-control effort by health care purchasers and insurers to limit health care spending and services and advance a market-oriented, profit-driven system. The impact of managed care on mission readiness and retention of active and reserve personnel is and will continue to be profound. The purpose of this research was to conduct a qualitative, phenomenological study (life experiences) of TriCare/managed care to explore the impact and the meaning of the experience on total force mission readiness of the U.S. Air Force and how managed care has changed nursing practice. The results reveal the significance of the impact of TriCare/managed care on total force readiness by identifying, through themes, meta-themes, and a representative model, the negative effect that economics is having on active duty and reserve force health and well-being.
任务准备状态取决于全体部队的健康状况以及军事医疗和护理服务的响应能力。管理式医疗已成为美国医疗保健领域的常态，包括国防部军事医疗系统。成本管理、健康维护组织及其他健康计划被定义为“管理式医疗”，这是医疗保健购买者和保险公司为限制医疗保健支出和服务，并推进以市场为导向、利润驱动的体系而做出的积极成本控制努力。管理式医疗对任务准备状态以及现役和预备役人员留用的影响已经并将继续产生深远影响。本研究的目的是对军事医疗保健系统（TriCare）/管理式医疗进行定性的现象学研究（生活经历），以探讨其对美国空军全体部队任务准备状态的影响及这种经历的意义，以及管理式医疗如何改变了护理实践。研究结果通过主题、元主题和一个代表性模型，揭示了军事医疗保健系统/管理式医疗对全体部队准备状态影响的重要性，确定了经济因素对现役和预备役部队健康与福祉产生的负面影响。
