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

Introduction: Many adults involved in the criminal justice system have various healthcare needs. The Veterans Health Administration (VHA) operates programs to connect criminal justice-involved veterans to healthcare, including primary care. This study examined veterans in the Veterans Justice Progra...

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Main Authors: Jack Tsai, Austin Lampros, Sean Clark, Anne Dunn, Thomas P. O’Toole
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Journal of Primary Care & Community Health
Online Access:https://doi.org/10.1177/21501319251348134
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author Jack Tsai
Austin Lampros
Sean Clark
Anne Dunn
Thomas P. O’Toole
author_facet Jack Tsai
Austin Lampros
Sean Clark
Anne Dunn
Thomas P. O’Toole
author_sort Jack Tsai
collection DOAJ
description Introduction: Many adults involved in the criminal justice system have various healthcare needs. The Veterans Health Administration (VHA) operates programs to connect criminal justice-involved veterans to healthcare, including primary care. This study examined veterans in the Veterans Justice Programs (VJP) to understand which veterans are not empaneled in VA primary care and their associated characteristics and service use. Methods: A retrospective cohort study was conducted with 20 395 veterans who participated in VJP in 2023. Data on sociodemographic characteristics, clinical status, primary care empanelment, and service utilization from VHA medical records were analyzed. Results: Across the country, about 88% of veterans in VJP were empaneled in primary care who attended a mean of 3.63 (SD = 4.63) primary care visits over 12 months compared to a mean of 0.18 (SD = 0.54) primary care visits among veterans not empaneled. Bivariate analyses found that empaneled veterans in VJP were significantly less likely to have any mental health or substance use disorder than non-empaneled veterans. However, multivariable analyses revealed the characteristics most strongly and significantly associated with empanelment in primary care among VJP veterans were use of outpatient medical care (aOR = 16.53, 95% CI = 9.32-31.43), use of outpatient mental health/substance use treatment (aOR = 1.83, 95% CI = 1.27-2.70), military sexual trauma (aOR = 1.66, 95% CI = 1.35-2.06), and being non-Hispanic black (aOR = 1.61, 95% CI = 1.35-1.96 compared to Hispanic black or white). Conclusions: Empanelment in primary care is associated with use of behavioral healthcare among criminal justice-involved veterans indicating opportunities for integrated care initiatives in VHA facilities.
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spelling doaj-art-bdfd4ac75ab34b3eb3703f700cd81fa92025-08-20T03:45:36ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272025-06-011610.1177/21501319251348134Criminal Justice-Involved Veterans Not Engaged in Primary Care in the Veterans Health AdministrationJack Tsai0Austin Lampros1Sean Clark2Anne Dunn3Thomas P. O’Toole4Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USAHomeless Programs Office, U.S. Department of Veterans Affairs (VA) Central Office, Washington, DC, USAHomeless Programs Office, U.S. Department of Veterans Affairs (VA) Central Office, Washington, DC, USAHomeless Programs Office, U.S. Department of Veterans Affairs (VA) Central Office, Washington, DC, USAWarren Alpert Medical School of Brown University, Providence, RI, USAIntroduction: Many adults involved in the criminal justice system have various healthcare needs. The Veterans Health Administration (VHA) operates programs to connect criminal justice-involved veterans to healthcare, including primary care. This study examined veterans in the Veterans Justice Programs (VJP) to understand which veterans are not empaneled in VA primary care and their associated characteristics and service use. Methods: A retrospective cohort study was conducted with 20 395 veterans who participated in VJP in 2023. Data on sociodemographic characteristics, clinical status, primary care empanelment, and service utilization from VHA medical records were analyzed. Results: Across the country, about 88% of veterans in VJP were empaneled in primary care who attended a mean of 3.63 (SD = 4.63) primary care visits over 12 months compared to a mean of 0.18 (SD = 0.54) primary care visits among veterans not empaneled. Bivariate analyses found that empaneled veterans in VJP were significantly less likely to have any mental health or substance use disorder than non-empaneled veterans. However, multivariable analyses revealed the characteristics most strongly and significantly associated with empanelment in primary care among VJP veterans were use of outpatient medical care (aOR = 16.53, 95% CI = 9.32-31.43), use of outpatient mental health/substance use treatment (aOR = 1.83, 95% CI = 1.27-2.70), military sexual trauma (aOR = 1.66, 95% CI = 1.35-2.06), and being non-Hispanic black (aOR = 1.61, 95% CI = 1.35-1.96 compared to Hispanic black or white). Conclusions: Empanelment in primary care is associated with use of behavioral healthcare among criminal justice-involved veterans indicating opportunities for integrated care initiatives in VHA facilities.https://doi.org/10.1177/21501319251348134
spellingShingle Jack Tsai
Austin Lampros
Sean Clark
Anne Dunn
Thomas P. O’Toole
Criminal Justice-Involved Veterans Not Engaged in Primary Care in the Veterans Health Administration
Journal of Primary Care & Community Health
title Criminal Justice-Involved Veterans Not Engaged in Primary Care in the Veterans Health Administration
title_full Criminal Justice-Involved Veterans Not Engaged in Primary Care in the Veterans Health Administration
title_fullStr Criminal Justice-Involved Veterans Not Engaged in Primary Care in the Veterans Health Administration
title_full_unstemmed Criminal Justice-Involved Veterans Not Engaged in Primary Care in the Veterans Health Administration
title_short Criminal Justice-Involved Veterans Not Engaged in Primary Care in the Veterans Health Administration
title_sort criminal justice involved veterans not engaged in primary care in the veterans health administration
url https://doi.org/10.1177/21501319251348134
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