Cost and Workload Accounting and Information Systems in Military Hospitals

GAO surveyed the accounting and information systems used to evaluate cost and workload in the Department of Defense's (DOD) military hospitals.

There were no standard accounting and information systems for recording and reporting comparable data among the facilities surveyed. To make rough comparisons of cost and output at three military hospitals visited, it was necessary to adjust some financial and other data produced; comparisons disclosed indications of disparity in the allocation of resources. The military services used numerous automated and manual systems to accumulate data, and the systems lacked uniformity. As a result, DOD did not have information available to compare and evaluate hospital budgets, costs, and workloads. Operation and budgeting procedures varied among the military services, and the budgets submitted by the services did not include the same cost elements. The Army excluded utility and maintenance costs, the Air Force excluded food procurement costs, and the Navy excluded dental operations costs. Since these cost elements were not included in the budget, they were not accounted for by the hospitals. It was difficult to determine total costs for medical care at each hospital, and these costs exclusions negated valid comparisons.