Related Experiment Video
Updated: Jun 26, 2026
06:55
Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
State of Surgical Readmissions Within the Military Health System (2020-2023)
Felicia Yeboah Denteh1,2, Amanda L Banaag1,2, Hongyan Wu1,2
1From the Center for Health Services Research, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD.
Summary
Healthcare disparities persist in the Military Health System. Black and Hispanic patients experienced higher 90-day surgical readmission rates, particularly in direct care settings, indicating ongoing challenges.
Area of Science:
- Healthcare disparities research
- Military health systems analysis
- Surgical outcomes research
Background:
- Racial disparities in healthcare outcomes are a persistent concern in the U.S.
- The Military Health System (MHS) may face exacerbated inequalities due to factors like reduced surgical volume, staffing shortages, and the COVID-19 pandemic.
- Previous studies suggested reduced disparities within the MHS, but recent challenges may have altered this landscape.
Purpose of the Study:
- To evaluate current healthcare disparities within the Military Health System.
- To compare healthcare outcomes between Department of Defense (DoD) facilities and civilian sector treatment.
- To assess 90-day readmission rates among TRICARE beneficiaries undergoing surgery.
Main Methods:
- Retrospective cohort study utilizing healthcare claims data from 2020-2023.
- Analysis of 90-day inpatient readmission following surgical procedures in adult TRICARE beneficiaries.
- Multivariable logistic regression and interaction analyses examining race, care setting, Charlson Comorbidity Index (CCI) score, and patient characteristics.
Main Results:
- A total of 262,344 surgeries were analyzed.
- Black patients with a CCI of 0 showed increased 90-day readmissions in both private sector hospitals (AOR=1.19) and direct care facilities (AOR=1.08).
- Hispanic patients with a CCI of 1 had higher readmission rates in direct care settings (AOR=1.14).
Conclusions:
- Significant increases in 90-day readmissions were observed for Black and Hispanic patients, particularly in direct care settings, correlated with CCI scores.
- These findings suggest that recent challenges impacting staffing and surgical volume in direct care facilities may be contributing to healthcare disparities.
- Further investigation into the factors driving these disparities within the MHS is warranted.
Related Concept Videos
01:29Issues And Trends In Healthcare Delivery System
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:31Discharge Summary Forms
The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:14SBAR II: Application of SBAR
SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...