More than 67,000 claims from a national database were analyzed to determine the relative costs of treating pediatric patients with asthma in physicians' offices, hospital outpatient departments, or emergency rooms. Billed charges and paid claims for these cases in emergency rooms average more than 5 times higher than in physician offices. Emergency treatment generally results from a failure of proper management and education in the primary care setting. Educational programs for pediatric patients with asthma and their families could save resources as well as reduce the trauma often associated with visits to the emergency room.

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An analysis was conducted of consumption of ancillary services by medical treatment facility special programs within the Military Health Service System (MHSS). This workload would not receive explicit credit under the new weighted ambulatory visit/inpatient disposition workload credit system mandated by the National Defense Authorization Act for Fiscal Year 1987. Results indicated that ancillary workload consumption by facility special programs was substantial. When the weighted visit/disposition workload credit system is implemented throughout MHSS, appropriate adjustments must be made to reflect ancillary workload generated by MHSS facilities in support of direct patient care missions but lost under this type of credit system.

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