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Deriving Costs and Effectiveness Data for U.S. Army Training-Garrison Pre-Hospital U.S. Army Emergency Medical Services

Lieutenant Colonel. Ralph Jay Johnson III*

This article reports on preliminary efforts to derive accurate cost-effectiveness data for US Army training-garrison installations’ Pre-Hospital Emergency Medical Services (PH-EMS) pursuant to “best practices” in the research literature. Recent attempts to collect US Army training-garrison PH-EMS effort (i.e., activity) measures revealed disparate cost accounting, thus giving rise to concerns and mobilizing exploratory studies on accurately, comparably, and comprehensively measuring these costs. A civilian PH-EMS project’s (the EMS Cost Analysis Project (EMSCAP)) vetted costing tool chest was generously borrowed from and conceptually adapted. Considerations of costs naturally and logically led to further consideration of performance outcomes (i.e., effectiveness). Pursuant to “best practices” in the research literature, the American College of Surgeons Outcomes measuring approach was generously drawn on. It is hoped that the preliminary work reported herein will not only answer questions about costeffectiveness and inform policy decisions, but also serve as a road map for others similarly challenged.
Keywords: EMS; Cost-effectiveness; Methods; Measurement; U.S. Army; Garrison; Training; Installation