title: The orthopedic specialty care management team: the McDonald Army Health Center experience.
abstract: The influx of war injuries taxes the military health care system already hard hit by large numbers of deployed military medical personnel. The purpose of this article is to present the business practices and results of our Orthopedic Specialty Care Management Team program for evaluation and possible replication at sister military treatment facilities who care for "Warriors in Transition". Our program witnessed a 10-week decrease in time until initial orthopedic evaluation and a 16-week decrease in time until initial surgical scheduling. There was a 77.5% increase in surgeries performed (group 1, 129 vs. group 2, 229). The total surgical case load for the orthopedic surgery service increased by 28.3% (group 1, 412 vs. group 2, 529). Our service productivity increased by 76% or 6801 relative value units, although the mean length of stay decreased by 4.1% or 6.9 days. The total cost savings is an estimated $373,766. The program, as modeled, increased access to care for the war-injured soldiers without negatively impacting the usual business practices of the service.
authors.affiliation: Department of Specialty Care, U.S. Armed Forces Judo and Soccer, McDonald Army Health Center, 576 Jefferson Avenue, Fort Eustis, VA 23604, USA.
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Johnson
authors.forename: Christopher
authors.initials: C
authors.lastname: Roach
authors.forename: Deborah
authors.initials: D
authors.lastname: Jolissaint
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D008297:Male; D008887:Military Medicine; D008889:Military Personnel; D009140:Musculoskeletal Diseases / Q000601:surgery*; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D012189:Retrospective Studies; D013503:Surgery Department, Hospital / Q000458:organization & administration*; D014481:United States; D055815:Young Adult