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Preventive care of older urban American Indians and Alaska natives in primary care

TitlePreventive care of older urban American Indians and Alaska natives in primary care
Publication TypeJournal Article
Year of Publication2001
AuthorsBuchwald, D, Furman, R, Ashton, S, Manson, S
JournalJ Gen Intern MedJ Gen Intern Med
Date PublishedApr
ISBN Number0884-8734 (Print)<br/>0884-8734 (Linking)
Accession Number11318927
KeywordsAge Factors, Aged, Alaska/ethnology, Audiometry/utilization, Guideline Adherence/ standards, Humans, Indians, North American, Influenza Vaccines/supply & distribution, Mammography/utilization, Occult Blood, Pneumococcal Vaccines/supply & distribution, Practice Guidelines as Topic, Preventive Medicine/ methods, Primary Health Care, Smoking Cessation, Urban Population
AbstractLittle is known about prevention among elderly or urban American Indian/Alaska Native (AI/AN) populations. We reviewed the medical records of 550 older urban AI/AN primary care patients to evaluate how frequently preventive measures were received. Adherence to guidelines was examined by a culturally appropriate (> or =50 years) and standard age threshold (> or =65 years), and by performance of preventive measures at any time ("ever") and in the past year. Lifetime performance was inadequate for the many measures, including mammograms (56%), fecal occult blood testing (37%), audiometry (33%), visual acuity testing (50%), smoking cessation counseling (50%), and pneumococcal (22%) and influenza (49%) vaccinations. Performance of the measures was less frequent in the prior year, but did not differ by age threshold. Predictors of adherence included female gender, having insurance, and having more health problems and medications. Nonadherence infrequently resulted from patients' failure to comply with recommendations. We conclude that use of most preventive services among elderly urban AI/ANs is suboptimal and should be improved.
Ethno Med: