title: Patient satisfaction and loyalty among military healthcare beneficiaries enrolled in a managed care program.
abstract: OBJECTIVE
  A study was performed to evaluate military beneficiaries' motivation for choosing to change from a civilian managed care system to the military managed care system.
  
  
  BACKGROUND
  Concerns about healthcare cost, quality, and access underpin major reform in military healthcare. The military health system (MHS) is implementing managed care through an initiative known as TRICARE. Patient choice and satisfaction are highly relevant to all healthcare delivery systems; they are being explored aggressively in the MHS as TRICARE evolves.
  
  
  METHODS
  This descriptive study was conducted using a telephone survey consisting of 63 items derived from four pre-existing instruments as well as five facility-specific questions and demographics. The population of interest targeted military beneficiaries on a TRICARE waiting list who, at the time of enrollment, indicated a desire to receive care at the military facility.
  
  
  RESULTS
  Consumers were inclined to return to the military system because of loyalty. Also, this study provided evidence that staff courtesy is important to those who seek healthcare. Good quality and accessibility were verified as essential elements in sustaining a consumer's positive view of and attraction to a particular healthcare system. Cost was proven to be a less substantial factor of consumer decision making.
  
  
  CONCLUSIONS
  Surveys such as this give healthcare providers more information about aspects of care, such as patient loyalty and interpersonal dynamics, that attract people to their healthcare delivery systems. For healthcare systems to thrive, consumer influence and the power of patient dissatisfaction must be understood.
authors.affiliation: US Army Nurse Corps, Falls Church, Virginia, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Jennings
authors.forename: L A
authors.initials: LA
authors.lastname: Loan
mesh_terms: D003284:Contract Services; D003657:Decision Making; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000592:standards*; D008875:Middle Aged; D008887:Military Medicine / Q000458:organization & administration / Q000592:standards*; D008889:Military Personnel / Q000523:psychology*; D009042:Motivation; D015205:Northwestern United States; D017060:Patient Satisfaction; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014481:United States