Health Disparities on American Indian Reservations: Can Mid-level Practitioners Make a Difference?
Physician Assistant M.S.
Introduction: American Indians/Alaskan Natives (AI/AN) suffer from a number of health issues and at higher rates than other United States populations. Efforts have been made through the Indian Health Service (IHS) to improve the AI/AN state of health, but healthcare disparities remain. Purpose: The purpose of this study was to assist in identifying options in reducing healthcare disparities on American Indian reservations in South Dakota. The need for recruitment of additional physicians and mid-level practitioners (also known as mid-level providers or advanced practice providers) was assessed, as well as the potential for mid-level practitioners to meet that need. Methods: A survey was sent to IHS physicians, physician assistants, and nurse practitioners within South Dakota. SurveyMonkey® was utilized to collect data. The survey was sent to nine reservation health facilities, with 54 potential participants. Results: Research questions revealed marginal satisfaction with access to supplies, neither satisfaction nor dissatisfaction with access to treatments, dissatisfaction with funding, a high frequency of rationing, healthcare factors needing improvement, satisfaction with workload, dissatisfaction with staffing, and a need for additional providers. Results also revealed physician assistants and nurse practitioners as unanimously valuable and having made a noteworthy impact, and mid-level providers act as viable and valuable additions to reservation healthcare facilities. Conclusions: This study revealed areas in need of improvement within the reservation healthcare system, and revealed ways to improve upon the reservation healthcare system. In addition, mid-level providers were found to be valuable and viable additions to reservation health facilities, and their presence has improved healthcare delivery within reservation communities.
Masters of Science in Physician Assistant
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Johnston, D. E. (2015). Health Disparities on American Indian Reservations: Can Mid-level Practitioners Make a Difference? [Masterʼs thesis, Bethel University]. Spark Repository. https://spark.bethel.edu/etd/336