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Study Assesses Outpatient Healthcare Use for American Indian and Alaska Native Women Veterans


American Indian and Alaska Native (AIAN) women are among the growing number of female Veterans who now seek VA healthcare. Many AIAN Veterans who are members of federally recognized Tribes may also be eligible for healthcare from the Indian Health Service (IHS). In 2003, VA and the IHS executed a Memorandum of Understanding (MOU) to improve access and health outcomes for AIAN Veterans by encouraging cooperation and resource sharing. In order to inform inter-agency planning and coordination, this study reports on the demographic characteristics and healthcare utilization patterns of AIAN women Veterans at the outset of the MOU agreement. Investigators analyzed IHS and VA data for AIAN women receiving outpatient care in either or both healthcare systems during FY02 and FY03. The 5,856 AIAN women in this study were categorized into three groups: IHS care only (36.2%), VHA care only (24.2%), and dual-users (39.7%). All of the women in the IHS-only and VHA-only groups were Veterans, but only one-third of the women in the dual-users group were Veterans.

Findings show that regardless of group, the medical needs of female AIAN Veterans were similar to other Veterans, including other female Veterans. On average, Veteran dual-users received two-thirds of their healthcare at VA facilities, while non-Veteran dual-users received most of their healthcare at IHS facilities. The lowest outpatient utilization rate was for IHS-only users. Results also show that three of the most frequent diagnoses were hypertension, diabetes, and depression. PTSD was a leading reason for a healthcare visit only at VA facilities. VA-only users received specialty care (78.5%) or mental health care (32.9%) twice as frequently as IHS-only users (39.4% and 15.0%, respectively). In addition, VA-only users received care in rehabilitation clinics (33.1%) or diagnostic clinics (64.6%) at least four times more frequently than IHS-only users (8.7% and 14.6%, respectively).

PubMed Logo Kramer B, Jouldjian S, Washington D, Harker J, Saliba D, Yano E. Healthcare for American Indian and Alaska Native women: The roles of the Veterans Health Administration and the Indian Health Service. Womens Health Issues Mar-April 2009;19(2):135-43.

This study was funded through HSR&D and the VA Greater Los Angeles Healthcare System. All authors are part of the VA Greater Los Angeles Healthcare System.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.