Patient satisfaction in military medicine: model refinement and assessment of Department of Defense effects.

A sample of 154,893 patient responses from the Customer Satisfaction Survey database was drawn for 1999 to 2000. Average patient satisfaction levels consistently appeared to be high (between 6, very satisfied, and 7, completely satisfied, on the 7-point rating scale). Hierarchical regression results essentially replicated all three major constructs of an earlier theoretical attitude model. Refinements included adjustment and addition of categorical age and military beneficiary status for individual patient variables, addition of two beliefs about the care itself, substitution of waiting time variables, and addition of reason for visit situation variables. Hypothesis test results indicated that patient satisfaction constructs were homogeneous across the uniformed services for patients from all service branches, both enrolled and not enrolled within TRICARE regions, and among branch of service medical center, hospital, and clinic facilities. The final attitude model coefficient of multiple determinations obtained was R2 = 0.701 [F(25,154,867) = 14,539.33, p < 0.0001].

Staffing model for dental wellness and readiness.

Oral health is an integral part of general health. Previous research has shown that untreated oral conditions can result in increased rates of disease and nonbattle injury for deployed soldiers. The purpose of this study was to develop models for U.S. Army dental wellness and readiness using a multivariate regression analysis approach. Staffing levels and dental wellness and readiness rates were examined for the first three quarters of fiscal year 2002 at 40 Army installations. Full regression model equations were developed for percent dental wellness and readiness using location, time, dental provider types, and basic training installation as predictor variables. Both models were shown to be statistically significant, with wellness R2 = 0.37, F12,107 = 5.18, p < 0.001 and readiness R2 = 0.23, F12,107 = 2.65, p < 0.01. Further tests of specific predictor effects revealed that wellness was significantly associated with the specialties of general dentistry, hygienists, and oral surgery, and that readiness was significantly associated with region and the oral surgery specialty. Results may be useful for the U.S. Army to identify the best practices in an effort to optimize dental wellness and readiness.