Access to Care and Diabetes Management Among Older American Indians With Type 2 Diabetes. (March 2017)

• Record Type: Journal Article
• Authors: Nicklett, Emily J.; Omidpanah, Adam; Whitener, Ron; Howard, Barbara V.; Manson, Spero M.
• Is Part Of: Journal of aging and health. Volume 29:Number 2(2017:Mar.)
• Page Start: 206
• Page End: 221
• Publication Date: 2017-03
• Subjects: American Indians -- diabetes -- health services -- access to care -- rural aging; Older people -- Health and hygiene -- Periodicals; Geriatrics -- Periodicals; 618.97
• DOI: 10.1177/0898264316635562
• Languages: English
• ISSNs: 0898-2643

Abstract

Objective: To examine the relationship between health care access and diabetes management among a geographically diverse sample of American Indians (AIs) aged 50 and older with type 2 diabetes.Method: We examined the relationship between access to care and diabetes management, as measured by HbA1c, using 1998-1999 data from the Strong Heart Family Study. A series of bivariate and multivariate linear models examined the relationships between nine access-related variables and HbA1c levels.Results: In bivariate analyses, out-of-pocket costs were associated with higher HbA1c levels. No other access-related characteristics were significantly associated with diabetes management in bivariate or in multivariate models.Discussion: Access-related barriers were not associated with worse diabetes management in multivariate analyses. The study concludes with implications for clinicians working with AI populations to enhance opportunities for diabetes management.