Research for USUHS

Syndicate content
Impact of Increasing Obligated Service for Physician Scholarships
October 1, 2003
This study estimates the impact of increasing the active duty obligation (ADO) for the Armed Forces Health Professions Scholarship Program (AFHPSP). We found that the amount by which accession requirements could decrease depends on the size of the graduate medical education (GME) program. Specifically, accession requirements and costs are less if the GME program were optimized than if it were fixed at current levels. If GME is fixed, many AFHPSP accessions are needed, not to fill billets, but simply to support the GME program. We find that increasing the ADO from 4 to 5 years for 4 years of subsidization is supportable. We based this finding on (1) recruiters’ perception that they could still meet the recruiting mission with a 5-year ADO, (2) the willingness of current AFHPSP students to consider and accept AFHPSP with a 5-year ADO, (3) the downward pressure on the medical billet file, and (4) the Services’ success in meeting recruiting goals that vary substantially from year to year. We find that increasing the AFHPSP ADO beyond 5 years is not warranted because it is not supportable from a recruiting standpoint and most AFHPSP students didn’t express a willingness to accept an obligation beyond 5 years.
Read More | Download Report
Life-Cycle Costs of Selected Uniformed Health Professions (Phase II: The Impact of Constraints and Policies on the Optimal-Mix-of-Accession Model)
April 1, 2003
We computed life-cycle costs for physicians, dentists, and other selected health care professions. Specifically, we computed the cost to access them, train them to be fully qualified duty special-ists, and maintain them in staff utilization tours. We computed the cost per year of practice (YOP) as a fully trained specialist with emphasis on the cost per YOP at the completion of the initial active duty obligation and at the expected YOP. We found that training costs are substan-tial—8 to 49 percent over compensation costs for physicians depending on specialty and acces-sion source. Given these life-cycle costs, we’ve developed a model to determine the optimal mix of acces-sions to fill future billet requirements. The optimum depends crucially on the model’s con-straints, which include the required experience profile, in-house training requirements, and ac-cession constraints. The results indicate that the required experience profile affects the optimum for physicians more than any other constraint, whereas in-house training requirements are the biggest driver in the dentist model. Looking at the impact of pay on the optimum, we found that accession bonuses are modestly cost-effective for some specialties and that targeted special pay increases are more cost-effective than across-the-board increases.
Read More | Download Report
Navy Specialty Physician Study: Historical Overview, Retention Analysis, and Synopsis of Current Civilian-Sector Practices
January 1, 2002
CNA performed the Navy Specilaty Physician Study at the request of the Navy Surgeon General. The objective of the study was to further explore retention of Navy physicians, by identifying and tracking critical indicators of Navy physician retention, to provide BUMED information for improving personnel policy business practices. Years of practice in specialty, percent board certified, number of residents and fellows, and demographics are some of the critical indicators we tracked by specialty. In recognition of the typical career path of Navy physicians, our retention analysis considered matriculation and attrition rates. We found that the matriculation rate of newly trained specialists has improved since FY 1987. We believe this is a result of the April 1988 active duty GME obligation policy change. To provide policy-makers some context and comparison for our findings, we explored some of the physician recruitment and retention strategies being used in the civilian sector. This information will help policy-makers better understand the Navy's competitive position when it competes for physicians.
Read More | Download Report