Excerpt

Numerous studies have demonstrated racial and ethnic disparities in health care in the United States.These disparities have been demonstrated in the Veterans Affairs (VA) healthcare system, where financial barriers to receiving care are minimized. The VA is committed to delivering high-quality care in an equitable manner, and as such, to eliminating racial and ethnic disparities in health care. To inform this effort, we systematically reviewed the existing evidence on disparities within the VA, to address the following objectives: 1) Determine in which clinical areas racial and ethnic disparities are prevalent within the VA; 2) Describe what is known about the sources of those disparities; and 3) Qualitatively synthesize that knowledge to determine the most promising avenues for future research aimed at improving equity in VA health care.

Contents

• PREFACE
• EXECUTIVE SUMMARY
• INTRODUCTION
  • Background
  • Scope and Key Questions
• METHODS
  • Literature Search and Strategy
  • Eligibility Criteria and Study Selection
  • Data abstraction and quality assessment
  • Evidence Synthesis and Data Presentation
  • Environmental Scan
• RESULTS
  • Arthritis and Pain Management
  • Cancer
  • Cardiovascular Diseases
  • Diabetes
  • HIV and Hepatitis C
  • Mental Health and Substance Abuse
  • Preventive and Ambulatory Care
  • Rehabilitative and Palliative Care
  • Other Clinical Topics
• ONGOING AND RECENTLY COMPLETED RESEARCH
• SUMMARY AND SYNTHESIS
  • Prevalence of disparities
  • Sources of disparities
  • Future Research Recommendations
• REFERENCES
• APPENDIX I SEARCH STRATEGY
• APPENDIX II INCLUSION/EXCLUSION CRITERIA
• APPENDIX III SEARCH AND SELECTION OF LITERATURE
• APPENDIX IV EVIDENCE TABLES

Prepared for: Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service, Washington, DC 20420.