Dual Use of Veterans Health Administration and Indian Health Service: Healthcare Provider and Patient Perspectives
| Autor: | Delight E. Satter, Leander Russell McDonald, B. Josea Kramer, Stella Jouldjian, Rebecca L. Vivrette |
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| Rok vydání: | 2009 |
| Předmět: |
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medicine.medical_specialty Attitude of Health Personnel Health Personnel Health administration Patient satisfaction Nursing Health care Medicine & Public Health Internal Medicine medicine Humans veterans rural health health care economics and organizations business.industry Health Policy Rural health Public health Health services research Middle Aged Focus group United States health services research United States Department of Veterans Affairs Patient Satisfaction United States Indian Health Service Female business patient preferences qualitative research Qualitative research |
| Zdroj: | Kramer, B. Josea; Vivrette, Rebecca L.; Satter, Delight E.; Jouldjian, Stella; & McDonald, Leander Russell. (2009). Dual Use of Veterans Health Administration and Indian Health Service: Healthcare Provider and Patient Perspectives. Journal of General Internal Medicine, 24(6), pp 758-764. doi: 10.1007/s11606-009-0962-4. Retrieved from: http://www.escholarship.org/uc/item/1x93t0z0 Journal of General Internal Medicine |
| ISSN: | 1525-1497 0884-8734 |
| DOI: | 10.1007/s11606-009-0962-4 |
| Popis: | BACKGROUND Many American Indian and Alaska Native veterans are eligible for healthcare from Veterans Health Administration (VHA) and from Indian Health Service (IHS). These organizations executed a Memorandum of Understanding in 2003 to share resources, but little was known about how they collaborated to deliver healthcare. OBJECTIVE To describe dual use from the stakeholders’ perspectives, including incentives that encourage cross-use, which organization’s primary care is “primary,” and the potential problems and opportunities for care coordination across VHA and IHS. PARTICIPANTS VHA healthcare staff, IHS healthcare staff and American Indian and Alaska Native veterans. APPROACH Focus groups were conducted using a semi-structured guide. A software-assisted text analysis was performed using grounded theory to develop analytic categories. MAIN RESULTS Dual use was driven by variation in institutional resources, leading patients to actively manage health-seeking behaviors and IHS providers to make ad hoc recommendations for veterans to seek care at VHA. IHS was the “primary” primary care for dual users. There was little coordination between VHA and IHS resulting in delays and treatment conflicts, but all stakeholder groups welcomed future collaboration. CONCLUSIONS Fostering closer alignment between VHA and IHS would reduce care fragmentation and improve accountability for patient care. |
| Databáze: | OpenAIRE |
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