| Title | Diabetes care among older urban American Indians and Alaska Natives |
| Publication Type | Journal Article |
| Year of Publication | 2004 |
| Authors | Rhoades, DA, Roubideaux, Y, Buchwald, D |
| Journal | Ethn DisEthn Dis |
| Volume | 14 |
| Pagination | 574-9 |
| Date Published | Autumn |
| ISBN Number | 1049-510X (Print)<br/>1049-510X (Linking) |
| Accession Number | 15724778 |
| Keywords | Aged, Alaska/ethnology, Diabetes Mellitus, Type 2/ ethnology/ therapy, Female, Health Services, Indigenous/ standards/utilization, Humans, Indians, North American/statistics & numerical data, Inuits/statistics & numerical data, Male, Medical Audit, Middle Aged, Prevalence, Primary Health Care/standards/utilization, Quality Indicators, Health Care, Regression Analysis, Urban Health Services/ standards/utilization, Urban Health/statistics & numerical data, Washington/epidemiology |
| Abstract | OBJECTIVE: To assess the prevalence of, and quality of care for, diabetes mellitus among the understudied, yet growing, population of older, urban American Indians and Alaska Natives (AI/ANs). DESIGN: Medical record review. SETTING: Urban Indian primary care clinic in Seattle, Washington. PATIENTS: All (N = 550) AI/AN patients > or = 50 years of age. MAIN OUTCOMES MEASURES: Provider-documented medical diagnoses and indicators of quality of care of diabetes. RESULTS: Diabetes mellitus was documented in 113 (21%) of the medical records. Persons with diabetes were more likely than those without (P > or = .05) to be obese, and to have hypertension, coronary artery disease, and depression. Most patients with diabetes were treated with either insulin (43%) or oral hypoglycemic medication (39%), but 16% received neither. Screening rates within 12 months were high for glycosylated hemoglobin (72%), lipid profile (84%), and foot examination (72%), but were low for urinalysis (23%), ophthalmology referral (23%), and influenza vaccination (46%). Only 46% of patients had ever received pneumococcal vaccination, and even fewer (26%) had received tuberculin skin testing (24%). Although 65% of patients had ever been referred to a dietitian, only 40% had received exercise counseling. The total number of health problems was the factor most often associated with quality of care indicators. CONCLUSIONS: The prevalence rate of diabetes among this urban clinic population of older AI/ANs was high. Although performance of quality indicators was suboptimal, it was comparable to, or better than, that found in other older populations for many measures. |
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