Military hospital system report shows disparities in care

A newly released report from the secretary of defense that reviewed the Military Health System (MHS) showed the system generally provides safe and timely care, but there are some disparities in care provided by the military. Eight facilities have "significantly higher than expected" rates of patients getting sick following treatment.

Accusations that the Department of Veterans Affairs suffered from extreme wait times and data manipulation that may have contributed to patient deaths prompted the review into the separate system run by the Defense Department that treats active-duty service members and their family, the Washington Post reported.

"The bottom line finding is that the military healthcare system provides healthcare that is comparable in access, quality and safety to average private sector healthcare. But we cannot accept average," Defense Secretary Chuck Hagel told reporters at a briefing on Wednesday, the Post reported. "We can do better."

Military hospitals, which care for 1.6 million active-duty service members and their families, don't often complete mandatory safety investigations after unexpected patient deaths or severe patient injuries, FierceHealthcare previously reported. Medical workers reported 239 unexpected deaths, but the Pentagon's patient safety center received only 100 inquiries from 2011 to 2013. The military system also had higher than expected rates of harm and complications to patients, specifically in maternity care and surgery.

The report recommends six steps to improve the system:

  1. Take immediate action to improve underperformance by identifying the cause of variance for military treatment facilities that are outliers for one or more measures and, when due to poor performance, develop corrective action plans to bring them within compliance.

  2. Establish clear enterprise performance goals with standardized metrics and hold the system accountable for improvement by developing a performance management system adopting a core set of metrics regarding access, quality, and patient safety. MHS should also conduct regular, formal performance reviews of the entire system.

  3. Make good decisions by relying on accurate data by developing a system-wide quality and patient safety data analytics infrastructure, to include health information technology systems, data management tools, and appropriately trained personnel.

  4. Show information to everyone including patients, providers and policymakers by emphasizing transparency of information, including both the direct and purchased care components.

  5. Drive the necessary change with MHS governance by providing the services with common executable goals. This effort would advance an understanding of the culture of safety and patient-centered care across the MHS.

  6. Leverage common standards and processes to drive improvement by developing common standards and processes. Design these processes to improve outcomes across the enterprise in the areas of access, quality and patient safety where this will improve quality, or deliver the same level of quality at better value.

MHS' healthcare cost the Pentagon $51.4 billion in fiscal 2012, which makes up 9.7 percent of military spending, compared to $19 billion, or 6 percent of spending, in 2001. That number may reach $65 billion by fiscal 2017 and $92 billion by 2030, according to Congressional Budget Office projections, FierceHealthcare previously reported.

To learn more;
- here's the report
- read the Post article