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B. Josea Kramer - One of the best experts on this subject based on the ideXlab platform.
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Do Correlates of Dual Use by American Indian and Alaska Native Veterans Operate Uniformly Across the Veterans Health Administration and the Indian Health Service
Journal of General Internal Medicine, 2011Co-Authors: B. Josea Kramer, Mingming Wang, Stella Jouldjian, Bruce Finke, Jeff Dang, Michael N. Mitchell, Debra SalibaAbstract:OBJECTIVE To determine if the combined effects of patient-level (demographic and clinical characteristics) and organizational-level (structure and strategies to improve access) factors are uniformly associated with utilization of Indian Health Service (IHS) and/or Veterans Health Administration (VHA) by American Indian and Alaska Native (AIAN) Veterans to inform policy which promotes dual use.
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Dual Use of Veterans Health Administration and Indian Health Service: Healthcare Provider and Patient Perspectives
Journal of General Internal Medicine, 2009Co-Authors: B. Josea Kramer, Stella Jouldjian, Rebecca L. Vivrette, Delight E. Satter, Leander Russell McdonaldAbstract: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.
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Dual Use of Veterans Health Administration and Indian Health Service: Healthcare Provider and Patient Perspectives
Journal of General Internal Medicine, 2009Co-Authors: B. Josea Kramer, Stella Jouldjian, Rebecca L. Vivrette, Delight E. Satter, Leander Russell McdonaldAbstract: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. 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. VHA Healthcare staff, IHS Healthcare staff and American Indian and Alaska Native veterans. Focus groups were conducted using a semi-structured guide. A software-assisted text analysis was performed using grounded theory to develop analytic categories. 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. Fostering closer alignment between VHA and IHS would reduce care fragmentation and improve accountability for patient care.
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Veterans Health Administration and Indian Health Service: Healthcare utilization by Indian Health Service enrollees.
Medical Care, 2009Co-Authors: B. Josea Kramer, Mingming Wang, Stella Jouldjian, Martin L. Lee, Bruce Finke, Debra SalibaAbstract:Background:The Veterans Health Administration (VHA) and Indian Health Service (IHS) have executed an agreement to share resources to improve access and Health outcomes for American Indian and Alaska Native (AIAN) veterans.Objectives:To describe the extent of dual use, Health needs, and utilization p
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Identification of American Indian and Alaska Native Veterans in Administrative Data of the Veterans Health Administration and the Indian Health Service
American Journal of Public Health, 2006Co-Authors: B. Josea Kramer, Mingming Wang, Bruce Finke, Tuyen Hoang, Judith O. Harker, Debra SalibaAbstract:We sought to determine the extent to which the Indian Health Service (IHS) identified enrollees who also use the Veterans Health Administration (VHA) as veterans. We used a bivariate analysis of administrative data from fiscal years 2002-2003 to study the target population. Of the 32259 IHS enrollees who received care as veterans in the VHA, only 44% were identified by IHS as veterans. IHS data underestimates the number of veterans, and both IHS and VHA need mechanisms to recognize mutual beneficiaries in order to facilitate better coordination of strategic planning and resource sharing among federal Health care agencies.
Deborah L. Wingard - One of the best experts on this subject based on the ideXlab platform.
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current smoking and type 2 diabetes among patients in selected Indian Health Service clinics 1998 2003
American Journal of Public Health, 2008Co-Authors: Deborah J. Morton, Mario D. Garrett, Jennifer Reid, Deborah L. WingardAbstract:Objectives. In non-American Indian/Alaska Native groups, current smoking prevalence is similar for those with or without diabetes (26%) We analyzed current smoking prevalence in American Indian/Alaska Natives by diabetes status.Methods. Data were extracted from Indian Health Service clinic visit information from 1998 to 2003. After consolidation into unique patient records, the sample comprised 71221 patients aged 14 years or older with both diabetes and current smoking information.Results. Cross-sectional results indicated that diabetic American Indian/Alaska Natives were significantly more likely than those without diabetes to be current smokers (29.8% vs 18.8%; P<.01). Smoking rates were 2 to 3 times higher among diabetic American Indians and Alaska Natives for each age category (P<.001), and current smokers with diabetes were more likely than nonsmokers to have glycosylated hemoglobin A1c levels at 8.0% or higher (P <.05).Conclusions. American Indian/Alaska Natives with diabetes at all sites and age c...
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Current smoking and type 2 diabetes among patients in selected Indian Health Service clinics, 1998-2003.
American Journal of Public Health, 2008Co-Authors: Deborah J. Morton, Mario D. Garrett, Jennifer Reid, Deborah L. WingardAbstract:Objectives. In non-American Indian/Alaska Native groups, current smoking prevalence is similar for those with or without diabetes (26%) We analyzed current smoking prevalence in American Indian/Alaska Natives by diabetes status.Methods. Data were extracted from Indian Health Service clinic visit information from 1998 to 2003. After consolidation into unique patient records, the sample comprised 71221 patients aged 14 years or older with both diabetes and current smoking information.Results. Cross-sectional results indicated that diabetic American Indian/Alaska Natives were significantly more likely than those without diabetes to be current smokers (29.8% vs 18.8%; P
Nathaniel Paul - One of the best experts on this subject based on the ideXlab platform.
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Indian Health Service injury prevention program us department of Health and human Services
2020Co-Authors: Nathaniel PaulAbstract:Native American individuals experience injury mortality at rates that far exceed the rates of injury mortality of other Americans. High rates of injury mortality among Native American populations pose not only a large social burden but also a large financial burden due to treatment expenses. The Indian Health Service Injury Prevention Program seeks to reduce the number and severity of injuries in all Native Americans. To fulfill this mandate, the Indian Health Service Injury Prevention Program provides preService and in-Service training to students, community workers, and professionals in the field of injury prevention. It emphasizes creation of innovative training opportunities for federal and tribal employees as part of a system of injury control in American Indian communities throughout the United States. Several Indian Health Service Injury Prevention Program initiatives have yielded improvement in injury and fatality rates for their targeted populations.
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Indian Health Service Injury Prevention Program/US Department of Health and Human Services
Casebook of Traumatic Injury Prevention, 2019Co-Authors: Nathaniel PaulAbstract:Native American individuals experience injury mortality at rates that far exceed the rates of injury mortality of other Americans. High rates of injury mortality among Native American populations pose not only a large social burden but also a large financial burden due to treatment expenses. The Indian Health Service Injury Prevention Program seeks to reduce the number and severity of injuries in all Native Americans. To fulfill this mandate, the Indian Health Service Injury Prevention Program provides preService and in-Service training to students, community workers, and professionals in the field of injury prevention. It emphasizes creation of innovative training opportunities for federal and tribal employees as part of a system of injury control in American Indian communities throughout the United States. Several Indian Health Service Injury Prevention Program initiatives have yielded improvement in injury and fatality rates for their targeted populations.
Stella Jouldjian - One of the best experts on this subject based on the ideXlab platform.
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Do Correlates of Dual Use by American Indian and Alaska Native Veterans Operate Uniformly Across the Veterans Health Administration and the Indian Health Service
Journal of General Internal Medicine, 2011Co-Authors: B. Josea Kramer, Mingming Wang, Stella Jouldjian, Bruce Finke, Jeff Dang, Michael N. Mitchell, Debra SalibaAbstract:OBJECTIVE To determine if the combined effects of patient-level (demographic and clinical characteristics) and organizational-level (structure and strategies to improve access) factors are uniformly associated with utilization of Indian Health Service (IHS) and/or Veterans Health Administration (VHA) by American Indian and Alaska Native (AIAN) Veterans to inform policy which promotes dual use.
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Dual Use of Veterans Health Administration and Indian Health Service: Healthcare Provider and Patient Perspectives
Journal of General Internal Medicine, 2009Co-Authors: B. Josea Kramer, Stella Jouldjian, Rebecca L. Vivrette, Delight E. Satter, Leander Russell McdonaldAbstract: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.
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Dual Use of Veterans Health Administration and Indian Health Service: Healthcare Provider and Patient Perspectives
Journal of General Internal Medicine, 2009Co-Authors: B. Josea Kramer, Stella Jouldjian, Rebecca L. Vivrette, Delight E. Satter, Leander Russell McdonaldAbstract: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. 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. VHA Healthcare staff, IHS Healthcare staff and American Indian and Alaska Native veterans. Focus groups were conducted using a semi-structured guide. A software-assisted text analysis was performed using grounded theory to develop analytic categories. 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. Fostering closer alignment between VHA and IHS would reduce care fragmentation and improve accountability for patient care.
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Veterans Health Administration and Indian Health Service: Healthcare utilization by Indian Health Service enrollees.
Medical Care, 2009Co-Authors: B. Josea Kramer, Mingming Wang, Stella Jouldjian, Martin L. Lee, Bruce Finke, Debra SalibaAbstract:Background:The Veterans Health Administration (VHA) and Indian Health Service (IHS) have executed an agreement to share resources to improve access and Health outcomes for American Indian and Alaska Native (AIAN) veterans.Objectives:To describe the extent of dual use, Health needs, and utilization p
Leander Russell Mcdonald - One of the best experts on this subject based on the ideXlab platform.
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Dual Use of Veterans Health Administration and Indian Health Service: Healthcare Provider and Patient Perspectives
Journal of General Internal Medicine, 2009Co-Authors: B. Josea Kramer, Stella Jouldjian, Rebecca L. Vivrette, Delight E. Satter, Leander Russell McdonaldAbstract: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.
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Dual Use of Veterans Health Administration and Indian Health Service: Healthcare Provider and Patient Perspectives
Journal of General Internal Medicine, 2009Co-Authors: B. Josea Kramer, Stella Jouldjian, Rebecca L. Vivrette, Delight E. Satter, Leander Russell McdonaldAbstract: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. 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. VHA Healthcare staff, IHS Healthcare staff and American Indian and Alaska Native veterans. Focus groups were conducted using a semi-structured guide. A software-assisted text analysis was performed using grounded theory to develop analytic categories. 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. Fostering closer alignment between VHA and IHS would reduce care fragmentation and improve accountability for patient care.