TY - JOUR
T1 - Increasing the neurosurgical caseload at a military hospital
T2 - Initial experience with a joint military-Veterans Affairs (VA) sharing agreement
AU - Ragel, Brian T.
AU - Taggard, Derek A.
AU - Klimo, Paul
AU - Liu, Jeannette M.
AU - Robison, Sandy
AU - Sholes, Anne H.
PY - 2009/2
Y1 - 2009/2
N2 - Objective: Neurosurgeons at David Grant Medical Center (DGMC) have had low surgeon case volumes. Meanwhile, veterans have had long waits because of inadequate neurosurgical coverage. DGMC and Department of Veteran Affairs (VA) agreed to share resources to treat an underserved VA patient population. We analyzed number of cases, admissions, relative weighted product (RWP), and outpatient visits before and after this unique military-VA agreement. Methods: Number of operations, hospital admissions, RWP, and outpatient visits (January 2004-November 2007) were noted before or after October 2006. To normalize data, metric (e.g., number of cases) totals were divided by number of months neurosurgeons were available. Results: Before the agreement, two neurosurgeons performed 210 operations over 52 months (4.0 cases/month). After the agreement, two neurosurgeons performed 177 cases over 26 months (6.8 cases/month). This corresponded to a 2.2-, 2.2-, and 2.0-fold increase in hospital admissions, RWP, and outpatient visits, respectively. Conclusions: The sharing agreement resulted in 1.7-fold increase in operative cases. This military-VA venture provides military neurosurgeons with more surgical cases and provides neurosurgical care to a previously underserved patient population. Reprint and
AB - Objective: Neurosurgeons at David Grant Medical Center (DGMC) have had low surgeon case volumes. Meanwhile, veterans have had long waits because of inadequate neurosurgical coverage. DGMC and Department of Veteran Affairs (VA) agreed to share resources to treat an underserved VA patient population. We analyzed number of cases, admissions, relative weighted product (RWP), and outpatient visits before and after this unique military-VA agreement. Methods: Number of operations, hospital admissions, RWP, and outpatient visits (January 2004-November 2007) were noted before or after October 2006. To normalize data, metric (e.g., number of cases) totals were divided by number of months neurosurgeons were available. Results: Before the agreement, two neurosurgeons performed 210 operations over 52 months (4.0 cases/month). After the agreement, two neurosurgeons performed 177 cases over 26 months (6.8 cases/month). This corresponded to a 2.2-, 2.2-, and 2.0-fold increase in hospital admissions, RWP, and outpatient visits, respectively. Conclusions: The sharing agreement resulted in 1.7-fold increase in operative cases. This military-VA venture provides military neurosurgeons with more surgical cases and provides neurosurgical care to a previously underserved patient population. Reprint and
UR - http://www.scopus.com/inward/record.url?scp=65549113427&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=65549113427&partnerID=8YFLogxK
U2 - 10.7205/MILMED-D-00-5408
DO - 10.7205/MILMED-D-00-5408
M3 - Article
C2 - 19317187
AN - SCOPUS:65549113427
SN - 0026-4075
VL - 174
SP - 103
EP - 105
JO - Military medicine
JF - Military medicine
IS - 2
ER -