Research for Evaluations

In October of 1992, the Tidewater area of Virginia was designated as a demonstration site for Tricare. The demonstration project makes fundamental changes in the financing and delivery of health care to military beneficiaries currently served by Naval Hospital, Portsmouth; McDonald Army Hospital, Ft. Eustis; and 1st Medical Group (TAC), Langley Air Force Base. Tricare Tidewater is a triservice managed-care initiative, designed to enhance military beneficiaries' access to care, improve mechanisms for quality assurance, control rising costs, and increase coordination between military and civilian components of the Military Health Services Systems (MHSS). Although increasing physician satisfaction was not a direct goal of the program, many of the changes implemented may affect the way that military physicians practice medicine in the Tidewater region and their attitudes regarding their role in the MHSS. Certainly, any positive effects would be welcomed, but a decline in physician satisfaction could lead to lower retention rates for military physicians, as well as lower levels of physician performance, patient satisfaction, and quality of care. In this research memorandum, we measure the impact of the first two years of the Tricare program on physician satisfaction.

For many years, the Center for Naval Analyses (CNA) has been charged with reconstructing and analyzing the Navy's major fleet exercises. Before deploying, a carrier battle group completes its work-up cycle by participating in a major exercise war. CNA provides reconstruction and analysis support at the request of the fleet commanders, who need an objective evaluation of their battle group's tactics and readiness. On 26 and 27 September 1995, Commander, Naval Base San Diego and Fleet Industrial Supply Center, Sand Diego hosted the 1995 San Diego Preparedness for Response Exercise Program (PREP) Area Exercise. This report documents our evaluation methodology, and offers a suggested evaluation plan for use in future PREP area exercises.

The purpose of this paper is to present a rationale for evaluating minimum qualifiying standards that incorporate policy guidance and directives together with data from the Job Performance Measurement (JPM) project. First, policy guidance and directives are discussed and defined more precisely for use in quantitative analyses. The policy statements are then applied to results from the JPM project to compute a minimum qualifying aptitude score for the infantry occupational field.

This study examines the Navy periodic depot maintenance program for aircraft. It includes evidence that Navy aircraft are inducted for periodic depot level maintenance (PDLM) too often and that too many maintenance man-hours are expended when they are given PDLM. The rework man-hours being expended at depot are not directly related to operational factors but rather to the fact that maintenance managers have strong incentives to err on the side of safety by doing more maintenance and doing it more often than is needed. An alternatiave PDLM program based on decision logic and reliability is offered which corrects this situation and allows a continuous appraisal of PDLM interval and work content. Before such a system can be adopted by the Navy, more component reliability data than are now available will be required. While the requisite data are being gathered, basing intervals on flying hours and continuing the Navy's Aircraft Condition Evaluation program offer improvements in determining depot maintenance requirements. Minimization of risk is achieved by reliability sampling techniques.