2048. Feasibility of Merging VA and Indian Health Service Administrative Data
B. Josea Kramer, PhD, VA Greater Los Angeles Healthcare System, GRECC, JO Harker, VA Greater Los Angeles Healthcare System, M Wang,
VA Greater Los Angeles Healthcare System, HSR&D, D Saliba,
VA Greater Los Angeles Healthcare System, GRECC, HSR&D, B Fincke,
Indian Health Service, Office of Clinical and Preventive Services, Elder Care Initiative
Objectives: Demonstrate the feasibility of merging VA and IHS administrative databases for utilization research; identify and evaluate data merger problems and solutions which can be applied to resolve these issues; describe demographic and health characteristics of American Indian veterans who are dual-users or single-users of VA and IHS healthcare.
Methods: Using a common unique identifier, link and merge patient treatment files for FY 99 and FY00, which are maintained by VA Austin Automation Center and the IHS National Patient Information Reporting System. Data were evaluated using descriptive statistics and logistic regressions to test a priori hypotheses.
Results: Few discrepancies were identified in the merged data, however in VA records misclassification by race/ethnicity was 12% to 29%. Twenty-three per cent of American Indian veterans used both VA and IHS; dual users were significantly older than veterans who used IHS only. Service connection did not predict use of VA. Most dual-users received VA care within the VISN of residence, but inpatient and outpatient care was also provided in other VISNs.
Conclusions: It is feasible to merge VA and IHS administrative data for health services research.
Impact: Many American Indian and Alaska Native veterans are eligible for care from both VA and IHS, but the extent of dual use is unknown. Analyses of these administrative data present a unique opportunity to identify gaps and potential overlaps in care, to improve access, and to optimize efficiencies between federal providers.