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Center on Native Elder Health Disparities

The Quality of IHS Native Elder Diabetes Care

Project Leader: Yvette Roubideaux, M.D., M.P.H.

Diabetes is a serious problem for American Indians who suffer from some of the highest rates of diabetes in the world. Our preliminary work suggests that diabetes education is the strongest predictor of completion of recommended examinations, laboratory tests, and immunizations in the care of patients with diabetes. The Indian Health Service (IHS) has developed criteria to classify diabetes education programs into differing levels based on the extent of the organization and delivery of these services.

The purpose of this 3-year study is to determine whether there are significant differences in the quality of diabetes care among Indian health programs with differing levels of diabetes education programs. Our hypothesis is that patients who receive care in Indian health facilities with more comprehensive diabetes education programs will have higher rates of completion on indicators of diabetes care, and that facilities that become more comprehensive over time will also demonstrate higher levels of care.

This study addresses the following specific aims:

  1. Determine if there are significant differences among Indian health facilities with differing levels of diabetes education programs in their performance on selected process and outcome indicators of diabetes care using the IHS Diabetes Audit;
  2. Determine which diabetes education program and facility characteristics are associated with better performance on indicators of diabetes care;
    The results of this study could be a first step in providing data on whether the IHS criteria used to evaluate and develop diabetes education programs are evidence-based, and on what program and facility characteristics are associated with improved quality diabetes care in the Indian health system.

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