Health Service Access, Use, and Insurance Coverage Among American Indians/Alaska Natives and Whites: What Role Does the Indian Health Service Play?

Zuckerman, Stephen; Haley, Jennifer; Roubideaux, Yvette; Lillie-Blanton, Marsha

doi:10.2105/ajph.94.1.53

Cited by 205 publications

(146 citation statements)

References 3 publications

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“…This may be particularly true since there are large discrepancies in health care among American Indians who qualify for and who utilize the health care offered by the IHS and those who do not. 11,12 However, data from another study we are performing suggests that vaccination is indeed high throughout the Navajo population. In that study, 86% of Navajo ≥65 years old and living in the community were vaccinated (authors' data).…”

Section: Discusionmentioning

confidence: 95%

Delivering Pneumococcal Vaccine to a High Risk Population: The Navajo Experience

Benin

Watt²,

O’Brien³

et al. 2005

Human Vaccines

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High rates of preventable diseases such as pneumococcal disease occur among the Navajo despite their universal health insurance through the Indian Health Service. The objective of this study was to determine the proportion of Navajo adults vaccinated with pneumococcal polysaccharide vaccine and to examine key features of vaccination programs of the Navajo Indian Health Service. For this cross-sectional study, medical charts of Navajo patients with vaccine indications were randomly selected and reviewed to determine who had been vaccinated as of January 1, 1999. Among 480 Navajo >65 years old, 73% were vaccinated (95% confidence interval [CI]: 69%-77%). Among 111 Navajo 18-64 years old with vaccine indications, 54% were vaccinated (95% CI: 45%-63%). Vaccination programs utilized extensive public health nursing, home visits, standing orders, and "express lane" clinics. In spite of excellent delivery systems and universal healthcare, the proportion of Navajo persons vaccinated was still below the goals for Healthy People 2010 of having 90% of persons ≥65 years old vaccinated and 60% of high-risk persons 18-64 years old vaccinated.

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Section: Discusionmentioning

confidence: 95%

Delivering Pneumococcal Vaccine to a High Risk Population: The Navajo Experience

Benin

Watt²,

O’Brien³

et al. 2005

Human Vaccines

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show abstract

“…All respondents in the present study had free access to Indian Health Service (IHS) care, which generally addresses more acute and emergent conditions. Zuckerman, Haley, Roubideaux, and Lillie-Blanton (2004) reported that AI/ANs with only IHS coverage were signifi cantly less likely than insured Whites to have had preventive services. AI/ANs in Zuckerman et al's study were also less likely than Whites to use basic medical care, including health professional/doctor visits, and were signifi cantly more likely to visit an emergency room.…”

Section: Good Health Daysmentioning

confidence: 99%

Conceptualizing Native Identity with a Multidimensional Model

Gonzalez

Bennett

2011

AIANMHR

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“…The Indian Health Service provides access to care that is similar to insurance, according to one study. 22 And according to the federal government's actuarial estimates, the Indian Health Service spends roughly half of what it would cost to cover its core population through private insurance for federal employees, adjusting for differences in demographics, health characteristics, and covered services. 23 This level of funding is widely regarded as inadequate for patients who require referrals for advanced hospital and specialist services that are not immediately available from Indian Health Service providers.…”

Section: Estimated Costs From Massachusettsmentioning

confidence: 99%

Model Safety-Net Programs Could Care For The Uninsured At One-Half The Cost Of Medicaid Or Private Insurance

2011

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Because the reforms under the Affordable Care Act of 2010 will leave an estimated twenty million or more people still uninsured, some Americans will continue to seek care at low or no cost through existing safety-net systems. To identify appropriate care models, this comparative case study assessed the costs of care provided by four large, wellstructured, comprehensive safety-net programs for the uninsured in Colorado, Michigan, North Carolina, and Texas. The average monthly resource cost-including the value of referred, donated, and in-kind services-in these model programs was $141-$209 per adult in 2008. This was 25-50 percent less than the estimated cost of care for comparison groups covered by local Medicaid programs or by private insurance that provided similar services. Although these programs' services are somewhat less comprehensive than those of generous insurance plans, the findings suggest that these model safety-net programs could be adapted to provide an alternative type of coverage for the uninsured, including both low-income and middle-class people.

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Health Service Access, Use, and Insurance Coverage Among American Indians/Alaska Natives and Whites: What Role Does the Indian Health Service Play?

Abstract: The IHS partially offsets lack of insurance for some uninsured AIANs, but important needs were potentially unmet.

Cited by 205 publications

References 3 publications

Delivering Pneumococcal Vaccine to a High Risk Population: The Navajo Experience

Delivering Pneumococcal Vaccine to a High Risk Population: The Navajo Experience

Conceptualizing Native Identity with a Multidimensional Model

Model Safety-Net Programs Could Care For The Uninsured At One-Half The Cost Of Medicaid Or Private Insurance

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