title: A first report of the Department of Defense external civilian peer review of medical care.
abstract: In mid-1985, the Department of Defense announced a plan for an external civilian peer review of selected medical and surgical cases in military hospitals. A medical advisory panel consisting of practicing clinical representatives from nine medical specialty societies helped develop written criteria and standards for specific surgical and medical cases. Abstracted data were compared with computer algorithms created from the medical standards and criteria. Those cases failing the review criteria were reviewed by a physician peer review panel. The sampled medical records represented approximately 7% to 8% of the total hospital discharges. Less than 1% of the overall sampled cases were in noncompliance with stated standards. The highest rate of noncompliance was for cases of diabetic ketoacidosis. The most frequent noncompliance event was hysterectomy. Although comparisons are not available, the quality of care among selected cases, as measured by compliance with civilian physician specialty group-endorsed standards, appeared high.
authors.affiliation: Department of Defense (Health Affairs), Washington, DC.
authors.forename: W
authors.initials: W
authors.lastname: Mayer
authors.forename: J J
authors.initials: JJ
authors.lastname: Clinton
authors.forename: D
authors.initials: D
authors.lastname: Newhall
mesh_terms: D000465:Algorithms; D003625:Data Collection / Q000379:methods; D006772:Hospitals, Military / Q000592:standards; D008499:Medical Records; D008887:Military Medicine / Q000592:standards*; D010380:Peer Review / Q000379:methods*; D014481:United States