Analysis of the MTFS: Active Duty Ambulatory Care Visits at US Army Medical Treatment Facilities in 1999. Volume 3

The purpose of this study was to examine all 1999 active duty (AD) use of the Army's ambulatory treatment facilities, characterize various levels of use, and identify what constitutes a high user. Data were obtained from the DoD Ambulatory Data System as Standard Ambulatory Data Records. Data on Physical Evaluation Boards from the U.S. Army Physical Disability Agency were added to the visit records. A total of 4,727,815 visits made by 647,017 patients were analyzed. Data were summarized by five views: (1) Overall, (2) Top 30 Primary Diagnoses visits, (3) Top 10% High Users, (4) High User Outliers (total visits exceeded 3 standard deviations above mean), and (5) Low Users (1-4 visits). In each view, three subsets of data were examed: Army-wide, by medical treatment facility (except for Top 30 Diagnoses), and Region 6. Five appendices present detailed summaries including total visits and age statistics, and frequency tables of visit and patient demographics and diagnoses and procedures. Mean number of AD visits Army-wide was 7.3 Overall compared to 54.1 for Outliers and 2.2 for Low Users. Noticeable differences between high and low users were identified. Data summaries indicate High User Outliers are likely to be patients: (1) with alcohol dependency/other mental disorder, (2) recovering from surgery/injury and requiring physical therapy/other rehabilitation, (3) female with normal pregnancies, or (4) with chronic back/lower leg joint pain. Logistic regression analyses found several factors significantly associated with being an Outlier including specific categories of gender, marital status, age group, patient beneficiary category, military rank, and number of physical therapy clinic visits.