Healthcare Quality in the Department of Defense

Beauvais, Brad; Brezinski, Paul; Schmacker, Eric R

doi:10.3200/htps.86.4.33-37

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…However, the strength of this study is that it is a large, racially- and geographically-diverse cohort with fewer discrepancies in health care access than those seen in the general US population. The MHS’ patient population, delivery systems, and quality of care parallel those found in private sector health systems in the United States 26 , 27 ; thus, our findings are likely generalizable to the US patient population at large. The MHS Data Repository is a valuable resource that can be leveraged to further explore quality of care metrics such as the Health People 2030 objectives and to track outcomes such as kidney failure incidence rates, morbidity, and mortality rates in a distinct global health care system.…”

Section: Discussionmentioning

confidence: 53%

Prevalence and Characteristics of CKD in the US Military Health System: A Retrospective Cohort Study

et al. 2022

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Section: Discussionmentioning

confidence: 53%

Prevalence and Characteristics of CKD in the US Military Health System: A Retrospective Cohort Study

et al. 2022

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“…The MHS' patient population, delivery systems, and quality of care parallel those found in private sector health systems in the United States [27,28]. This integrated and “closed” system allows its beneficiaries to be followed longitudinally, regardless of location [27].…”

Section: Discussionmentioning

confidence: 99%

“…The MHS is a global, comprehensive, integrated medical network within the US Department of Defense (DoD) that serves a diverse beneficiary population of 9.6 million active and retired service members and their families [26,27]. The MHS beneficiaries enjoy a comprehensive health care benefit, with access to primary and subspecialty care through both a direct and purchased network worldwide [28]. As such, we hypothesized that patients within the MHS would have greater access to pre-ESRD care and be more likely to achieve pre-ESRD quality indicators, with associated improved early survival after chronic dialysis initiation.…”

Section: Introductionmentioning

confidence: 99%

Pre-End-Stage Renal Disease Care and Early Survival among Incident Dialysis Patients in the US Military Health System

Nee¹,

Fisher²,

Yuan³

et al. 2017

Am J Nephrol

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Background: Previous reports showed an increased early mortality after chronic dialysis initiation among the end-stage renal disease (ESRD) population. We hypothesized that ESRD patients in the Military Health System (MHS) would have greater access to pre-ESRD care and hence better survival rates during this early high-risk period. Methods: In this retrospective cohort study, using the US Renal Data System database, we identified 1,256,640 patients initiated on chronic dialysis from January 2, 2004 through December 31, 2014, from which a bootstrap sample of 3,984 non-MHS incident dialysis patients were compared with 996 MHS patients. We assessed care by a nephrologist and dietitian, erythropoietin administration, and vascular access use at dialysis initiation as well as all-cause mortality as outcome variables. Results: MHS patients were significantly more likely to have had pre-ESRD nephrology care (adjusted OR [aOR] 2.9; 95% CI 2.3-3.7) and arteriovenous fistula used at dialysis initiation (aOR 2.2; 95% CI 1.7-2.7). Crude mortality rates peaked between the 4th and the 8th week for both cohorts but were reduced among MHS patients. The baseline adjusted Cox model showed significantly lower death rates among MHS vs. non-MHS patients at 6, 9, and 12 months. This survival advantage among MHS patients was attenuated after further adjustment for pre-ESRD nephrology care and dialysis vascular access. Conclusions: MHS patients had improved survival within the first 12 months compared to the general ESRD population, which may be explained in part by differences in pre-ESRD nephrology care and vascular access types.

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Military Health System Efficiency: A Review of History and Recommendations for the Future

et al. 2012

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This article reviews the history of measuring military medical health care efficiency. No single approved definition or uniform framework has ever been offered or suggested defining military medical treatment facility efficiency over the last 225 years within the Department of Defense. The purpose of this article is to consolidate much of the existing research on the latent variable of military medical efficiency over the last two centuries, and to provide health care leaders a framework for understanding past and current practices in measuring efficiency in the military health care setting.

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Healthcare Quality in the Department of Defense

Cited by 3 publications

References 2 publications

Prevalence and Characteristics of CKD in the US Military Health System: A Retrospective Cohort Study

Prevalence and Characteristics of CKD in the US Military Health System: A Retrospective Cohort Study

Pre-End-Stage Renal Disease Care and Early Survival among Incident Dialysis Patients in the US Military Health System

Military Health System Efficiency: A Review of History and Recommendations for the Future

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