Military barracks: poor living conditions undermine quality of life and readiness
Abstract: DOD houses hundreds of thousands of service members in military barracks. Reports of poor conditions have raised questions about DOD’s management of barracks. The Joint Explanatory Statement and Senate Report 117-39, accompanying bills for the National Defense Authorization Act for Fiscal Year 2022, included provisions for GAO to review DOD’s efforts to maintain and improve military barracks. This report examines, among other things, the extent to which DOD has (1) reliably assessed barracks conditions, (2) made informed decisions on barracks funding, and (3) conducted oversight to improve barracks. GAO analyzed DOD policies, budgets, and other documentation; interviewed DOD housing officials; toured barracks at a non-generalizable sample of 10installations; and met with installation officials and barracks residents.
Abstract: Context: In response to the opioid crisis, federal guidelines were implemented, including the Veterans Health Administration's (VA) Opioid Safety Initiative in 2013. The impact of policies on patients near the end of life is unknown. Objective: Examine temporal trends in opioid prescribing, pain, and opioid overdoses among Veterans near the end of life. Methods: Retrospective, time series analysis of VA decedents between October 2009 and September 2018 whose next-of-kin participated in VA's Bereaved Family Survey (BFS). Using multivariate regression to adjust for sociodemographic and clinical covariates, we examined temporal trends in outpatient opioid prescribing, uncontrolled pain based on BFS report, and opioid overdose-related hospitalizations, in the last month of life, overall and by clinical diagnosis (cancer versus non-cancer). Results: Among 79,409 decedents, mean daily outpatient opioid dose in morphine milligram equivalents in the last month of life decreased from 4.6 mg in 2010 to 2.1 mg in 2018 (adjusted change -0.20 mg/year; P