Criminal Justice-Involved Veterans Not Engaged in Primary Care in the Veterans Health Administration

Area of Science:

• Health Services Research
• Veterans Health
• Criminal Justice Health

Background:

• Many adults in the criminal justice system have unmet healthcare needs.
• The Veterans Health Administration (VHA) aims to connect justice-involved veterans to care, including primary care.
• Understanding primary care enrollment gaps in Veterans Justice Programs (VJP) is crucial for improving veteran healthcare access.

Purpose of the Study:

• To identify characteristics of veterans in VJP not empaneled in VA primary care.
• To analyze service utilization patterns among empaneled and non-empaneled VJP veterans.
• To inform integrated care strategies within VHA facilities for this population.

Main Methods:

• Retrospective cohort study of 20,395 veterans in VJP (2023).
• Analysis of sociodemographic data, clinical status, and VHA service utilization.
• Comparison of primary care empanelment rates and associated factors.

Main Results:

• 88% of VJP veterans were empaneled in primary care, attending significantly more visits than non-empaneled veterans.
• Non-Hispanic Black veterans, those with military sexual trauma, and users of outpatient medical or mental health/substance use treatment were more likely to be empaneled.
• Empaneled veterans were less likely to have mental health or substance use disorders in bivariate analyses.

Conclusions:

• Primary care empanelment among justice-involved veterans is associated with behavioral healthcare utilization.
• Findings support integrated care initiatives to improve healthcare access and outcomes for veterans in VJP.
• Targeted outreach and integrated services may enhance VHA's effectiveness for this vulnerable population.