Altarum Analysis on Readmission Rates Yields Insights for Continuous Improvement in the Military Health System 

New analysis by Altarum published in Health Affairs shows that seven and thirty-day unplanned readmission rates in the Military Health System (MHS) have fallen in the last eight years amid ongoing efforts by MHS to improve quality of care over the same period. The study also provides in-depth data and analysis on readmission rates by treatment service for military leadership to identify additional targets for health policy and interventions for continuous improvement in health outcomes and readiness.

Altarum examined seven and thirty-day unplanned readmission rates based on Military Health System and TRICARE claims data from FY 2011 to 2018 for patients aged 18 to 64. Below are highlights from the study:

• Seven-day readmission rates decreased from a high of 2.6 percent in FY 2011 to a low of 2.2 percent in FY 2018. Thirty-day readmission rates followed a similar pattern but at much higher levels, decreasing from 6.1 percent to 5.4 percent.
• Medical services had the highest readmission rates for seven-day readmissions (3.3 percent) and thirty-day readmissions (8.8 percent) while obstetrics had the lowest rates for seven-day readmissions (1.5 percent) and thirty-day readmissions (3.2 percent).
• Diagnoses within the following four of the 25 Major Diagnostic Categories accounted for over half of the unplanned seven and thirty-day readmissions: diseases and disorders of the digestive system; diseases and disorders of the circulatory system; diseases and disorders of the musculoskeletal system and connective tissue; and pregnancy, childbirth, and puerperium.
• Obstetric services had the lowest readmission rates at 1.5 percent for seven-day readmissions and 3.2 percent for thirty-day readmissions. Even so, obstetrics represents the largest share of admissions in the system at 41 percent so interventions in this area could still have notable impact.

The Military Health System serves nearly 10 million active duty uniformed service members, retirees, and their families. Readmission rates are important to examine as they are an established indicator of quality of care. Furthermore, reducing readmission rates also can improve inpatient experience, reduce mortality and lengths of stay, minimize cost, and improve readiness.

The study was conducted by Craig Holden, PhD, of Altarum; Kimberley Marshall-Aiyelawo, PhD, of the Defense Health Agency; Chantell Frazier, PhD, of Altarum; Joseph Dorris, MS, of Altarum; Tara Fowler, PhD, of Altarum; Mitchell Mismash, MPH; Jenifer Meno, PhD, of the Defense Health Agency; and Koji Nishimura, MD, of the Defense Health Agency.

Read the full study in the August issue of Health Affairs: Prevalence of Unplanned Readmissions Among Patients of Military Treatment Facilities.