Performance Improvement 1998. Indian Health Service

02/01/1998

Contents

Evaluation of the Impact of the Alaska Tribal Health Compact on Programs and Services in the Anchorage Service Unit, Alaska Area

Prior Trauma Care of Intoxicated Patients as a Predictor of Subsequently Fatal Injury

TITLE: Evaluation of the Impact of the Alaska Tribal Health Compact on Programs and Services in the Anchorage Service Unit, Alaska Area

ABSTRACT: This evaluation is the first research undertaken to systematically study the perceptions of a wide range of beneficiaries, officials, and employees of the Indian Health Service (IHS) and the tribal system regarding the Alaska Tribal Health Compact, Title III Self-Governance Demonstration Project. There are almost 200 federally recognized tribes in a single Area-wide Compact, organized via 13 separate consigners-each of which has its own Annual Funding Agreement. Seven of these consigners are in the Anchorage Service Unit, which is one of nine Service Units in the Alaska Area. The overall conclusion of the evaluation is that there are more village representatives who have seen either no change or a negative change in in-village services than those who have seen a positive change. The perceptions of the officials and employees of the Alaska Native Medical Center and the Alaska Area Native Health Service have revealed problems in staff morale and shifts in workload resulting from Compact consigners transferring patients to the Alaska Native Medical Center who were previously treated outside the Anchorage Service Unit. These changes are considered as having a negative impact on the Anchorage Service Unit. The "microcosmic" view from the Ahtna Region indicates that there is a distinct difference in the perception of those who are participating in the Compact and those who are not participating. The analysis of the village respondent data, comparing the information that came from the Title III villages with the information from the Title I villages, further solidified the conclusion that individuals in villages that are not served by a Compact consigner hold a consistently more negative view than those who live in villages that are serviced by a Compact consigner.

AGENCY SPONSOR: Office of Public Health

FEDERAL CONTACT: Leo J. Nolan

PHONE NUMBER: (301) 443-4245

PIC ID: 6407

PERFORMER ORGANIZATION: Alaska Native Health Board, Anchorage, AK

TITLE: Prior Trauma Care of Intoxicated Patients as a Predictor of Subsequently Fatal Injury

ABSTRACT: This study was undertaken to identify intervention opportunities associated with nonfatal, alcohol-related injury contacts in Indian Health Service emergency departments and clinics that could, over time, decrease alcohol-related injury deaths in the Billings Area Indian Health Services. The concept was to determine the frequency of injury treatment recidivism, both alcohol- and nonalcohol-related, and further to determine if patterns can be established to suggest that injury death is predictable based on those previous nonfatal contacts. The findings indicate a high degree of recidivism and a strong correlation between non-fatal incidents and eventual injury death. This study further reveals that there is a high prevalence of alcohol in nonfatal injury-related incidents among this cohort. There appears to be a strong relationship between repeated episodes of nonfatal injury with alcohol as a contributing factor and subsequently fatal events among this cohort. These nonfatal episodes should serve as warning signals and opportunities for the application of effective alcohol intervention strategies.

AGENCY SPONSOR: Office of Public Health

FEDERAL CONTACT: Leo J. Nolan

PHONE NUMBER: (301) 443-4245

PIC ID: 6451

PERFORMER ORGANIZATION: Billings Area Indian Health Service, Billings, MT

TOP OF DOCUMENT