Determining Navy Primary Care Requirements

There are basically two different approaches to determining requirements of staffing a primary-care-based system. Both approaches have their strengths and weaknesses, but we found that the optimization model, although technically feasible from a modeling point of view, wasn't an approach we could follow and complete. The primary disadvantages concern the need for certain kinds of data. To determine who should staff a primary care system and how generalists and specialists substitute for each other, you need to carefully define who can do what. We used HMO staffing ratios for a large number of medical subspecialities. After applying these ratios to Navy beneficiary populations at 22 U.S. naval hospitals and nine overseas naval hospitals, we derived the kinds of staffing that would be observed had the HMO provided care for these beneficiaries.