A first report of the Department of Defense external civilian peer review of medical care
W. Mayer, J. J. Clinton and D. Newhall 3rd
Department of Defense (Health Affairs), Washington, DC.
In mid-1985, the Department of Defense announced a plan for an external
civilian peer review of selected medical and surgical cases in military
hospitals. A medical advisory panel consisting of practicing clinical
representatives from nine medical specialty societies helped develop
written criteria and standards for specific surgical and medical cases.
Abstracted data were compared with computer algorithms created from the
medical standards and criteria. Those cases failing the review criteria
were reviewed by a physician peer review panel. The sampled medical records
represented approximately 7% to 8% of the total hospital discharges. Less
than 1% of the overall sampled cases were in noncompliance with stated
standards. The highest rate of noncompliance was for cases of diabetic
ketoacidosis. The most frequent noncompliance event was hysterectomy.
Although comparisons are not available, the quality of care among selected
cases, as measured by compliance with civilian physician specialty
group-endorsed standards, appeared high.
