Smaller military hospitals hurt patient outcomes

Many military hospitals are too small with too few patients to produce quality outcomes, according to a New York Times investigation.

Last year, two-thirds of military hospitals served no more than 30 inpatients a day and nine served no more than 10, according to the Times. The Pentagon is currently crafting a plan to reform the military hospital system, independent from efforts to revamp the Veterans Affairs (VA) system. The plan involves converting some hospitals into either birthing centers or outpatient clinics.

Healthcare costs comprise nearly 10 percent of the defense budget and close to half of military hospital beds are apparently vacant--substantially more than those of civilian facilities, according to the article.

The hospitals also struggle with hierarchical problems, as more experienced clinicians often advance to administrative positions, leaving inexperienced doctors with overwhelming frontline responsibilities and concern that the frequent rotation of doctors, hospital commanders and patients is detrimental to continuity of care. The wars in Iraq and Afghanistan exacerbate the problem, as personnel are called overseas and hospitals must relocate patients to the civilian healthcare system.

These problems have some veterans of military healthcare questioning whether the military should involve itself with healthcare at all.

"It's a dangerous game," John Schafer, former deputy commander for clinical operations at Reynolds Army Community Hospital in Oklahoma's Fort Sill, told the Times. "It is crazy that the military doesn't say, 'Hey, we are really good at outpatient medicine and this inpatient thing is out of our league.'"

The Pentagon began a systemwide review of care quality, patient safety and treatment access in late May, with the final report expected soon. The draft downsizing plan suggests the news is not good, according to the Times.

The latest investigation follows a Times report that found military hospitalslack clear patient safety standards and often don't complete required safety investigations after unexpected patient deaths or severe injuries, FierceHealthcare previously reported.

To learn more:
- read the article