Riegler J L, Takata J A, Schutz S M
Department of Gastroenterology/PSMG, Wilford Hall Medical Center, Lackland AFB, TX 78236, USA.
Mil Med. 1996 Aug;161(8):479-82.
The gastroenterology division at Wilford Hall Medical Center (WHMC) refers approximately 70% of outpatient consultations to civilian providers, a policy known as disengagement. This policy was implemented in the hope of reducing waiting times for appointments and testing. We conducted a telephone survey to determine whether disengaged patients eventually obtained health care and, if they did not, the reasons for this. We also attempted to determine the level of patient satisfaction with this policy. The results demonstrated that many patients did not obtain care within the 6-month follow-up period, largely because of financial considerations. Most patients were also dissatisfied with the policy and disappointed at not having obtained care at WHMC. The results of this study have important implications for Tricare, which might result in impaired access to care through out-of-pocket patient expenses related to cost-shares and membership fees.
威尔福德·霍尔医疗中心（WHMC）胃肠病学部将约70%的门诊会诊转介给民间医疗服务提供者，这一政策被称为“脱钩”。实施该政策的目的是减少预约和检查的等待时间。我们进行了一项电话调查，以确定脱钩患者最终是否获得了医疗服务，如果没有，原因是什么。我们还试图确定患者对该政策的满意度。结果表明，许多患者在6个月的随访期内未获得医疗服务，主要是出于经济考虑。大多数患者也对该政策不满意，并对未在WHMC获得医疗服务感到失望。这项研究的结果对特里卡尔医疗保险有重要影响，这可能会因与成本分摊和会员费相关的自付患者费用而导致获得医疗服务的机会受损。
