Telephone Survey of Ill and Injured Service Members Post Operational Deployment: Results After Eight

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• Telephone Survey of Ill and Injured Service
  Members Post Operational DeploymentResults
  After Eight Months
• January 29, 2008

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Background

• Tasking Telephone survey is one component of
  the multi-pronged strategy responding to SecDef
  direction (14 Mar 07) to
• Establish a mechanism to identify global issues,
  and increasingly sufficient in cumulative number
  to drill down and identify specific MTF issues to
  provide actionable information to the Services to
  resolve shortcomings related to Service members
  recuperating from illness or injury following
  return from Operation Deployment.
• HA Strategy (Force Health Protection and
  Readiness- FHPR Lead)
• Field telephonic survey to service members
  identified through TRANSCOM (US Transportation
  Command) Regulating And Command Control
  Evacuation System (TRAC2ES) (TRICARE Management
  Activity Health Programs Analsyis and
  Evaluation- HPAE).
• Maintain toll-free telephone access- business
  hours and days (FHPR).
• Field more detailed mail survey (TMA- HPAE).
• Strategy reviewed by Deputy Surgeons General (4
  Apr 07).

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Key Results

• Based on monthly telephone surveys from May
  December 2007of Service members medivacd from
  Operational Theater.
• Medical Hold/Holdover
• About one in four service members continue to
  rate poorly two areas related to their Medical
  Hold/Holdover experience (1) their ability to
  manage their military duties and personal
  affairs and (2) their experience with the
  Medical Evaluation Board (MEB) process (23-24
  of service members rate a 1 or 2 on a 5 point
  scale, with 1 poor 5 outstanding).
• Health Care and other support when receiving
  outpatient health care services
• Over one in five service members continue to rate
  poorly three of twelve questions all related to
  accessing health care services (1) Getting an
  appointment as soon as needed (2) Getting
  urgent care as soon as needed and (3) Getting
  treatment or counseling for a personal or family
  problem.
• One in five personnel rate their current overall
  health and/or overall mental health as a 1 or 2
  on a five point scale (1 poor 5 outstanding)
• Three- quarters indicate their health status is
  worse today than before they deployed.

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Medical Hold/HoldoverPercentage of Low (only)
Ratings over Time (Percentage Rating 1 or 2
on 5-point scale)
Preferred Direction
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Medical Hold/Holdover RatingsCumulative Results
May Dec 07
Focus on problem areas, but, significant levels
of satisfaction also
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Outpatient Health Care-Percentage of Low (only)
Ratings over Time (Percentage Rating 1 or 2
on 5-point scale)
Preferred Direction
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Outpatient Health Care RatingsCumulative Results
May Dec 07
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Self-Reported Health Status-Percentage of Low
(only) Ratings over Time (Percentage rating 1
or 2 on 5-point scale)
Preferred Direction
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Self-Reported Health StatusCumulative Results
May Dec 07
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Cumulative Medical Hold Comments After Eight
Months- By those rating an area a 1 or 2

• Service members are offered an opened question
  allowing them to voice their reasons as to why?
  if they responded with a 1 or 2 to the
  Medical Hold questions.
• Basic order and frequency of comments received in
  total, and each month, remains unchanged.
• Results based on non-statistical, qualitative
  analysis- cannot be generalized to population.
• Findings illustrate situations and themes
  reflecting survey respondents experiences
• Illustrates actionable responses to areas of
  dissatisfaction
• 1339 comments received across all monthly surveys
  (Ave. 100 - 300 comments)
• Managing duties/personal affairs received the
  most comments of any Medical Hold response with
  over one-fourth of all comments received (29).
  Of these, close to one fourth were related to
  injury and physical limitations. Close to
  another one fourth were related inability to
  sleep or think clearly, poor treatment, and
  separation from family.
• Health Care (16 of all comments) One half of
  these related to poor quality of healthcare
  and poor quality of providers while another
  one-fourth cited slow health care system and
  poor access to providers.
• Meeting attendees basic needs (16 of comments)
  about one-fourth of these related to lack of
  communication, and slow to inform family/next
  of kin, with about 1 in 10 comments related to
  each category of poor staff attitude, family
  not included on orders, lack of lodging for
  attendees.
• Managing ones basic needs (15 of comments
  received) with almost 60 percent of comments
  related to insufficient facilities, poor
  customer service/communications, quality of care
  and access to appointments.
• Lodging/Quarters/billeting (11 of all comments),
  with one fourth of these related to poor
  facility maintenance and cleanliness, and then
  overcrowding and staff not helpful (about
  11 each),

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Comment Examples
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Comment Examples
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Comment Examples
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Comment Examples
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Comment Examples
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Comment Examples
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Telephone Survey Sample Returns

• This is the eighth status report, following
  completion of each monthly telephone survey
• Telephone census of all ill or injured service
  members, US and overseas, flown out of
  operational theaters (Operations Enduring Freedom
  and Iraqi Freedom), and not in inpatient status.
• Almost 2,313 responded of nearly 5,042 surveyed,
  aeromedically evacuated (aerovacd) between
  December 1, 2006 and December 31 2007 with an
  overall adjusted response rate of almost 42
  (averaging between 41-51 response rate each
  month).
• Surveying reaching almost real time most
  recent survey sample was pulled two weeks after
  those aerovacd out of theater (e.g. aerovacd
  between 1-31 October, sample pulled 15 November,
  surveyed beginning end of November, early
  December).
• Majority of sample across all months is Army
  (82) and Marines (9) as well as responses
  (Army- 81, Marines- 10).
• Ratings most questions used 1 (poor) to 5
  (outstanding) scale to rate experience with
  health care services or support

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Sample Time Frame, Size and Response Rates

• Eligibles Service members returned from
  operational deployment via Aerovac, listed in
  TRAC2ES,
• not inpatient, not deployed back to theater
• American Association for Public Opinion
  Research (AAPOR Table RR3)

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Questions- Medical Hold

• While on Medical Hold, Holdover, Extension or
  awaiting Medical Board Status
• How would you rate your temporary lodging or
  quarters?
• If respondent hesitates or seems confused, offer
  Please think about the condition and
  cleanliness of your lodging or quarters, the
  adequacy of the furniture, the level of noise,
  pest control, temperature of the quarters, its
  utilities (such as water, electricity, and
  plumbing), parking, communications, and other
  amenities.
• How would you rate how your basic needs are/were
  met?
• Think about the adequacy and quality of food,
  transportation, recreation facilities and
  services, spiritual support and language
  interpretation services.?
• How would you rate the system in meeting the
  needs of those who helped you?
• How the system met the needs of those who helped
  you through the process during your time in Med
  Hold status, such as your family, friends,
  non-medical attendees or significant others.
• Now, think about your Medical Evaluation Board
  experience how would you rate your experience
  with the MEB process?
• Please consider whether you had a representative
  and, if so, your ability to contact that
  representative whether you had information and
  knowledge about the process, whether you were
  given timely responses to your questions and
  explanation of how decisions were made, and your
  understanding of your appeal rights.
• If responds yes to have you been referred to a
  PEB? How would you rate your experience with
  the PEB?
• How would you rate your experience with your
  ability to manage your military duties and
  personal affairs?
• Please, think about your ability to communicate
  and connect with unit members or your chain of
  command, emotional and physical support from your
  command, ability to replace uniforms, being
  gainfully employed, getting assistance with
  legal, pay and allowances, and eligibility issues
  for family and friends.
• How would you rate your health care experience?
• As you think about your health care experience,
  please consider such things as your ability to
  see providers, getting an appointment,
  rehabilitative services, getting medical
  equipment, and transportation for getting to and
  from appointments.

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Questions- Outpatient Care Support

• If answer yes to Since your return from your
  last deployment, have you received any outpatient
  care other than while on Medical Hold status?
• How would you rate the adequacy of transportation
  for medical care at the location?
• How would you rate the support provided to
  visiting family and friends while you received
  medical care?
• How would you rate how the way your pay issues
  were handled while you received medical care?
• How would you rate the handling of medical claims
  when you have received medical care?
• If answer yes to receiving civilian care and
  claims being sent.
• How would you rate the handling of your military
  personnel orders when you have received medical
  care?
• Please rate how well your familys needs were met
  while you received medical care?
• Please rate your experience getting care as soon
  as you thought you needed?
• If answered yes to did you have an illness,
  injury or condition that needed care right aware
  in a clinic, emergency room or doctors office?
• Not counting the times you needed care right
  away, please rate your experience getting an
  appointment for your health care at a doctors
  office or clinic as soon as you thought you
  needed?

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Questions- Health Status Doctors Rating

• Since your return from your most recent
  deployment
• Doctor ratings
• How would you rate your personal doctor?
• Defined personal doctor and member said yes
  to having a personal doctor.
• How would you rate the specialists youve seen
• Defined specialist and member said yes to
  seeing any.
• Health Status
• How would you rate your overall health?
• Compared to before you were deployed, how would
  you rate your health in general now? Would you
  say your health in general compared to before
  deployment is
• Much better, Somewhat better, About the same,
  Somewhat worse, Much Worse?
• What number would you use to rate your overall
  mental or emotional health now (1 5 scale)?
• Overall health Care
• 1. What number would you use to rate all your
  health care since returning from your most recent
  deployment?

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Medical Hold/Holdover-Ratings over Time
(Percentage Rating 1 or 2 on 5-point scale)
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Outpatient Health Care- Ratings over
Time(Percentage Rating 1 or 2 on 5-point
scale)
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Self-Reported Health Status- Ratings over Time
(Percentage rating 1 or 2 on 5-point scale)