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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.
The authors wish to thank Ruth Bayhelle, Dr. Nancy Reifel, Ms. Shena McLaren, Jessica Louie, Rebecca Harjo, Maria Carpiac, Dr. Rita Ledesma, and Mr. Jon-Jon Iyot for their efforts and contribution to this project. The authors wish to express their deepest appreciation to the veterans who participated in this study.
This work was supported by the Department of Veterans Affairs, Health Services Research and Development Service, grant number 00‐083‐1—V. M. Villa (PI), N. D. Harada (Co-PI).