Research Summaries

Back Variation in MEPS Disqualification Rates

Fiscal Year 2021
Division Graduate School of Business & Public Policy
Department Graduate School of Business & Public Policy
Investigator(s) Hartmann, Latika
Sponsor United States Military Entrance Processing Command (Army)
Summary Potential military recruits undergo an extensive medical screening to ensure they are physically and mentally fit to serve in the US military. Recruits must meet height and weight requirements, and perform a series of physical exercises. They undergo standard medical tests such as vision, hearing, blood pressure, HIV screening, drug screening among others, and complete a detailed medical history. They also go through a physical exam, an interview, and special tests if necessary. Recruits are disqualified from serving in the US military if they do not meet the standard as set by the DoD Instruction 6130.3, 2018. Some disqualifying conditions can be objectively identified through blood tests, while others rely perhaps more on the opinion of a medical professional.
In this project, we will study the variation in medical disqualification rates across 65 MEPS and 1 Remote Processing Substation (RPS) from 2010 to 2020. The factors correlated with disqualification rates fall into two broad groups. First, there are factors driven by the underlying population composition of the MEPS" specific locations. For example, if recruiters randomly draw recruits from the local population, we would expect disqualification rates to be higher for MEPS located in areas with poor underlying health. For example, obesity is more widespread in rural Southern counties compared to areas in the West or the Northeast (Michimi et al., 2010). All else equal, we would then expect the disqualification rates due to the obesity criteria to be higher for MEPS in the rural South compared to the West or Northeast regions. But, if the selection of recruits does not mirror the underlying location, this may not be the case. Indeed, we would expect recruiters to perhaps pre-screen recruits based on observable factors such as obesity.
Second, there are factors driven by the decision process or characteristics specific to individual MEPS, separate from applicants or location. For example, research suggests a significant variation in medical decision-making is unexplained by geography and patient characteristics. Rather, the individual background and characteristics of doctors affects their decisions. For example, a study of preoperative testing for cataract surgery found 36% of ophthalmologists order preoperative tests for 75% of their patients. Although these ophthalmologists treat only 26% of total patients, their patients account for 84% of all testing (Chen et al., 2015). In another study, physician characteristics were the strongest predictors of whether patients received hospice care (Obermeyer et al., 2015). Translating to the MEPS context, it may well be a small number of MEPS have very high disqualification rates compared to the average due to variation in their medical decision processes.
Our goal in this study is to (1) document the variation in raw disqualification rates across time and space, (2) identify MEPS and years with higher or lower than average disqualification rates i.e., outliers, (3) use regression analysis to identify uncontrollable (those driven by underlying recruiting population) and controllable factors that explain the differences in disqualification rates, and (4) recommend strategies to reduce the variation in disqualification rates. If the variation in disqualification rates is driven by applicant characteristics and geography, our analysis can inform the local recruiting community of the major demographic drivers in their area allowing them to develop potential strategies to improve their recruit quality. If the variation is driven by factors specific to the individual MEPS, we hope to identify the specific factors and offer suggestions to mitigate them.
Publications Publications, theses (not shown) and data repositories will be added to the portal record when information is available in FAIRS and brought back to the portal
Data Publications, theses (not shown) and data repositories will be added to the portal record when information is available in FAIRS and brought back to the portal