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Author List:
Kramer BJ (VA Greater Los Angeles Healthcare System)
Finke B (Indian Health Service)
Harker JO (VA Greater Angeles Healthcare System)
Hoang T (VA Greater Angeles Healthcare System)
Wang M (VA Greater Angeles Healthcare System)
Saliba D (VA Greater Angeles Healthcare System)
Objectives:
To identify variables in VA and Indian Health Service (IHS) administrative databases that can be linked in order to describe healthcare utilization patterns of American Indian veterans who are mutually eligible beneficiaries.
Methods:
We previously demonstrated that VA and IHS administrative data could be linked for individual veterans using social security numbers as unique identifiers. We obtained variable names and definitions for patient treatment files maintained by the VA at the Austin Automation Center and by the IHS at the National Patient Information Reporting System. We identified common variables that were amenable to comparison across the two systems.
Results:
IHS and VA administrative data share common variables that can be used to systematically compare utilization of mutual beneficiaries. Some variables have standardized definitions, such as date of birth, visit date, use of ICD-9 codes for diagnoses and CPT codes for procedures. Some variables differ in label definition but may be useful for comparison, such as matching the VA race variable with the IHS blood quantum variable to compare classification as Indian, Non-Indian or Unknown. VA inpatient data include all bed sections’ admission and discharge diagnoses, length of stay, DRG, etc. while IHS inpatient data include only the admission and discharge clinics and diagnoses and the overall length of stay. Currently, IHS national administrative data do not include medications or health care products and supplies; these elements are estimated to be available in 2006 through the IHS National Data Warehouse.
Implications:
Utilization patterns for in-patient and outpatient care, as well as contract care can be described for dual users of VA and IHS. The number of potential dual users can also be identified by comparing users of the two federal healthcare systems.
Impacts:
As VA VISNs and IHS Area Offices work to enact the 2003 Memorandum of Understanding to increase access and coordination, these administrative data are essential to identify gaps and potential overlaps in care and to design services to meet the needs of American Indian veterans.
