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. 2025 Jan-Dec:16:21501319251348134.
doi: 10.1177/21501319251348134. Epub 2025 Jun 17.

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

Jack Tsai  1   2 , Austin Lampros  1 , Sean Clark  1 , Anne Dunn  1 , Thomas P O'Toole  3   4
Affiliations

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

Jack Tsai et al. J Prim Care Community Health. 2025 Jan-Dec.

Abstract

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.

Keywords: behavioral health; criminal justice involvement; primary care; veterans.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Sean Clark is the national director of the Veterans Justice Programs. None of the other authors declare any potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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