Indian Health Service lacks accessibility to specialty care and other resources

The Native Times reports that the federally-run health system for American Indians & Alaska Natives has made substantial improvents in recent years but suffers from a lack of access to specialty care and other resources.

In new research from Brigham and Women’s Hospital (BWH), researchers describe trends in the quality of care and barriers to the delivery of care within the Indian Health Service. The IHS is a federal agency with a $4 billion budget that provides health care for 1.9 million American Indian/Alaska Natives.

Researchers conducted the largest analysis to-date of American Indian health care and observed significant improvements in the quality of care, but researchers also found barriers to delivering high quality care that may be due to resource constraints within the system.

Researchers evaluated clinical performance data for 12 measures of health care from 2002 to 2006 using information from the IHS electronic medical record system. They combined this with results from a physician survey completed in 2007 on access to health services and quality improvement strategies. Clinical performance improved substantially for a majority of clinical indicators, including those for diabetes care, heart disease care, and immunizations. However, physicians reported barriers to accessing many essential health services including specialist consultations and mental health care, for which resources are limited.

“The IHS, which serves approximately half of the American Indian population, has a per person budget that is substantially less than all other federal health care programs. This can contribute to important constraints in the clinical setting. For example, in the IHS only 29 percent of primary care physicians report adequate access to specialists; compared to studies that reveal 76 percent of primary care physicians have such access in the private sector,” Sequist said.

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