RESUMO
The military Health Care System provides comprehensive health care to entitled beneficiaries in a dual system consisting of hospitals and clinics at military installations, and an insurance like program (CHAMPUS) which pays for care in civilian facilities. Utilization by civilian beneficiaries was studied and compared with utilization by members of the Kaiser-Permanente Plan in Northern California, and the Non-Institutionalized Population of the United States. Hospital use rates for beneficiaries under CHAMPUS and in military facilities were calculated, and rough order of magnitude data were developed for utilization of hospitals outside of the Military Health Care System. Rates within the system were found to be lower than those of the noninstitutionalized population of the United States, partly because of utilization of hospitals outside of the Military Health Care System by entitled beneficiaries. However, rates were generally higher than those of Kaiser-Permanente (northern California) enrollees, despite the high use of hospital care by beneficiaries outside of the Military System. Systems factors impinging on hospital utilization rates are discussed. Ambulatory visit rates for beneficiaries in northern California to all types of providers were found to closely approximate those of the Kaiser-Permanente system, when all sources of care (within and outside of the system) are considered. Utilization within the Military Health Care System, however, is less than utilization by Kaiser beneficiaries. In general, civilian beneficiaries of the Military Health Care System were found not to be taking full advantage of their entitlement to health care.
