标题：Identification of American Indian and Alaska Native Veterans in Administrative Data of the Veterans Health Administration and the Indian Health Service
摘要：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. The Department of Veterans Affairs’ (VA) Veterans Health Administration (VHA) and the Department of Health and Human Services’ Indian Health Service (IHS) recently initiated, with a memorandum of understanding, an effort to improve coordination and resource sharing for veterans who are eligible for healthcare in both federal systems. 1 – 3 VHA provides comprehensive healthcare to veterans on the basis of a priority system that recognizes service-connected illness and disability, as well as need. IHS provides health-care to federally recognized tribes in 35 states. VHA, with its greater resources, appears to supplement IHS ambulatory services. 4 , 5 Despite high rates of military participation by American Indians and Alaska Natives, 6 , 7 which the US Census 2000 (Summary File 3, PCT66A-66H) reports as proportionately greater than other US race and ethnic groups, the number of veterans served by both federal systems is unknown. Currently, neither VHA nor IHS has administrative mechanisms in place to identify enrollees of the other system. However, IHS user data identify individuals as veterans, and interagency strategic planning is performed, in part, on the basis of these data. This report evaluates the accuracy of veteran identification data in IHS records to better inform the planning process for optimizing healthcare for American Indian and Alaska Native veterans.
