title: Health and ambulatory care use among Native American veterans.
abstract: In 1995, the Veterans Health Administration reorganized its health services structure to emphasize ambulatory care. Successful health care planning and improving access to ambulatory care services now depends upon a better understanding of health care needs and outpatient services. Because the veteran population is heterogeneous, it is important to understand the health, access issues, and utilization of ambulatory care services in order to develop effective strategies and interventions to ensure access to and utilization of ambulatory care. Drawing on a focus group methodology with 86 Native American veterans, representing 34 tribes, this study is a qualitative examination of the health, access, use of the Department of Veterans Affairs Health Care services, barriers to health care, and satisfaction with care experienced by Native American veterans. Results reveal problems in accessing care, receiving appropriate care, and coordinating care within the VA health care system. Policy and program recommendations include increasing outreach and education efforts regarding the availability of benefits and services, improving coordination of services between the Indian Health Service and the VA, and reemphasizing the importance of patient-centered care.
authors.affiliation: California State University, Los Angeles, Los Angeles, California 90032, USA. vvilla@ucla.edu
authors.forename: Valentine M
authors.initials: VM
authors.lastname: Villa
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Harada
authors.forename: Anh-Luu T
authors.initials: AL
authors.lastname: Huynh-Hohnbaum
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000523:psychology / Q000706:statistics & numerical data*; D001294:Attitude to Health; D002140:California; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009505:Nevada; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*