scholarly journals Health Care Experience Among Women Who Completed Group Prenatal Care (CenteringPregnancy) Compared to Individual Prenatal Care Within Military Treatment Facilities

2020 ◽  
Vol 7 (6) ◽  
pp. 1234-1240
Author(s):  
Tara Trudnak Fowler ◽  
Kimberley Marshall Aiyelawo ◽  
Chantell Frazier ◽  
Craig Holden ◽  
Joseph Dorris
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Health System ◽  
Care Program ◽  
The United States ◽  
Successful Implementation ◽  
Military Health System ◽  
Military Health ◽  
Individual Care ◽  
Enhanced Prenatal Care

This study compared TRICARE, the health care program of the United States Department of Defense Military Health System, beneficiaries in CenteringPregnancy, an enhanced prenatal care model, to women in individual prenatal care within the same military treatment facility. Maternity patient experience ratings from May 2014 to February 2016 were compiled from the TRICARE Outpatient Satisfaction Survey. Centering patients had 1.91 higher odds of being satisfied with access to care ( p < .01, 95% CI = 1.2-3.1) than women in individual care. Specifically, the saw provider within 15 minutes of appointment measure found Centering patients to have 2.00 higher odds of being satisfied than women in individual care ( p < .01, 95% CI = 1.2-3.3). There were no other statistically significant differences between cohorts. Qualitative responses indicate most Centering patients surveyed had good experiences, appreciated the structure and communication with others, and would recommend the program. Providers identified command/leadership support, dedicated space, and buy-in from all staff as important factors for successful implementation. Enhanced prenatal care models may improve access to and experiences with care. Program evaluation will be important as the military health system continues to implement such programs.

Racial Disparities in the Military Health System: A Framework Synthesis

2021 ◽  
Author(s):  
Tracey Pérez Koehlmoos ◽  
Jessica Korona-Bailey ◽  
Miranda Lynn Janvrin ◽  
Cathaleen Madsen
Keyword(s):  
Health Care ◽  
Health System ◽  
Racial Disparities ◽  
Women’S Health ◽  
Women's Health ◽  
Military Health System ◽  
Electronic Health Record Data ◽  
Military Health ◽  
Racial Disparities In Health ◽  
The Military

ABSTRACT Introduction Racial disparities in health care are a well-documented phenomenon in the USA. Universal insurance has been suggested as a solution to mitigate these disparities. We examined race-based disparities in the Military Health System (MHS) by constructing and analyzing a framework of existing studies that measured disparities between direct care (care provided by military treatment facilities) and private sector care (care provided by civilian health care facilities). Materials and Methods We conducted a framework synthesis on 77 manuscripts published in partnership with the Comparative Effectiveness and Provider-Induced Demand Collaboration Project that use MHS electronic health record data to present an overview of racial disparities assessed for multiple treatment interventions in a nationally representative, universally insured population. Results We identified 32 studies assessing racial disparities in areas of surgery, trauma, opioid prescription and usage, women’s health, and others. Racial disparities were mitigated in postoperative complications, trauma care, and cancer screenings but persisted in diabetes readmissions, opioid usage, and minimally invasive women’s health procedures. Conclusion Universal coverage mitigates many, but not all, racial disparities in health care. An examination of a broader range of interventions, a closer look at variation in care provided by civilian facilities, and a look at the quality of care by race provide further opportunities for research.

scholarly journals A Survey of Family Planning Training, Knowledge, and Practices Among Health Care Providers Within the Military Health System at Joint Base Lewis–McChord

2018 ◽  
Vol 184 (5-6) ◽  
pp. e394-e399 ◽  
Author(s):  
Elizabeth I Deans ◽  
Alison L Batig ◽  
Sarah Cordes ◽  
Alicia N Scribner ◽  
Peter E Nielsen ◽  
...  
Keyword(s):  
Health Care ◽  
Family Planning ◽  
Health System ◽  
Health Care Providers ◽  
Care Providers ◽  
Military Health System ◽  
Military Health ◽  
The Military

Assessing Low-Value Health Care Services In The Military Health System

2019 ◽  
Vol 38 (8) ◽  
pp. 1351-1357 ◽  
Author(s):  
Tracey Pérez Koehlmoos ◽  
Cathaleen King Madsen ◽  
Amanda Banaag ◽  
Adil H. Haider ◽  
Andrew J. Schoenfeld ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Services ◽  
Military Health System ◽  
Military Health ◽  
Care Services ◽  
The Military

Child, Family, and School Behavioral Health Care in the Military Health System

2020 ◽  
Vol 8 (3) ◽  
pp. 315-326
Author(s):  
Michael E. Faran ◽  
Patti L. Johnson ◽  
Paul K. Ban ◽  
James C. Sarver ◽  
Lindaya J. Brown ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Behavioral Health ◽  
Behavioral Health Care ◽  
Military Health System ◽  
Military Health ◽  
The Military

scholarly journals Impact of a Service Line Management Model on Behavioral Health Care in the Military Health System

2019 ◽  
Vol 70 (6) ◽  
pp. 522-525 ◽  
Author(s):  
Christopher G. Ivany ◽  
Kelly W. Bickel ◽  
Tari Rangel ◽  
James Sarver ◽  
Joann Dinkel-Holzer ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Behavioral Health ◽  
Behavioral Health Care ◽  
Management Model ◽  
Military Health System ◽  
Military Health ◽  
Service Line ◽  
The Military ◽  
Line Management

scholarly journals Examining Racial Disparities in Diabetes Readmissions in the United States Military Health System

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1679-e1685
Author(s):  
Dianne Frankel ◽  
Amanda Banaag ◽  
Cathaleen Madsen ◽  
Tracey Koehlmoos
Keyword(s):  
United States ◽  
Health System ◽  
The United States ◽  
Direct Care ◽  
Diabetic Patients ◽  
Military Health System ◽  
Military Health ◽  
Alaskan Native ◽  
Care System ◽  
White Patients

ABSTRACT Introduction Diabetes is one of the most common chronic conditions in the United States and has a cost burden over $120 billion per year. Readmissions following hospitalization for diabetes are common, particularly in minority patients, who experience greater rates of complications and lower quality healthcare compared to white patients. This study examines disparities in diabetes-related readmissions in the Military Health System, a universally insured, population of 9.5 million beneficiaries, who may receive care from military (direct care) or civilian (purchased care) facilities. Methods The study identified a population of 7,605 adult diabetic patients admitted to the hospital in 2014. Diagnostic codes were used to identify hospital readmissions, and logistic regression was used to analyze associations among race, beneficiary status, patient or sponsor’s rank, and readmissions at 30, 60, and 90 days. Results A total of 239 direct care patients and 545 purchased care patients were included in our analyses. After adjusting for age and sex, we found no significant difference in readmission rates for black versus white patients; however, we found a statistically significant increase in the likelihood for readmission of Native American/Alaskan Native patients compared to white patients, which persisted in direct care at 60 days (adjusted odds ratio [AOR] 11.51, 95% CI 1.11–119.41) and 90 days (AOR 18.42, 95% CI 1.78–190.73), and in purchased care at 90 days (AOR 4.54, 95% CI 1.31–15.74). Conclusion Our findings suggest that universal access to healthcare alleviates disparities for black patients, while Native America/Alaskan Native populations may still be at risk of disparities associated with readmissions among diabetic patients in both the closed direct care system and the civilian fee for service purchased care system.

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