CRIHB Research Documents for California Indians

Disparities in Hospitalizations of Rural American Indians

Nearly three-quarters (70%) of American Indians were misclassified in a race category other than American Indian or Alaska Native on California state hospital records.

The study corrected for this misclassification, and found that rural tribal American Indians in California who used Tribal Health Programs were hospitalized at rates 60% higher than non-Indian Californians living in the same counties.

When only hospitalizations that are categorized as ‘avoidable’ with access to optimal health care were included, the hospitalization rates of the tribal American Indians for avoidable diagnoses were found to be more than 100% higher than non-Indian Californians living in the same counties.

                Disparities in hospitalizations of Rural American Indians (pdf)


An editorial on the study appeared in the same issue of the journal.

               Editorial on hospitalizations of Rural American Indians (pdf)

            
Funding of Tribal Health Programs linked to Lower Rates of Hospitalization

This study found that the higher the Indian Health Service (IHS) funding of a Tribal Health Program (THP) the lower the hospitalizations of the categorized as ‘avoidable’ with access to optimal health care.

               IHS Funding Effects on THP (pdf)


Rural American Indian Medicaid Health Care Services Use and Health Care Costs in California

Rural tribal American Indians with Medicaid in California use less health care, and their providers received lower payments, when compared with Whites with Medicaid living in the same counties.

The American Indians who used Tribal Health Programs had significantly lower use of Medicaid-paid visits, prescriptions, emergency room visits, and hospitalizations than Whites. They also had lower Medicaid-paid costs. The use of care and costs were lower whether they used Tribal Health Programs more than other sources of health care, or not.

                Disparities in Medicaid use in CA (pdf)


An Electronic Health Record for Rural Indian Health Care: Evaluation of the Implementation

CRIHB partnered with three Tribal Health Programs to implement a commercial ambulatory electronic health record (NextGen EHR) and use the EHR for quality improvement of clinical care. This report tells the story of the lessons learned in the process.

               Electronic Health Record Implementation (pdf)


Cardiac Procedures among American Indians and Alaska Natives compared to Non-Hispanic Whites Hospitalized with Ischemic Heart Disease in California

AIAN in California hospitalized with heart disease were not less likely to receive surgical treatments that have been found to be beneficial than Whites.                

Cardiac Procedures Journal Article