Emily J Nicklett1, Adam Omidpanah2, Ron Whitener3, Barbara V Howard4, Spero M Manson5. 1. 1 University of Michigan School of Social Work, Ann Arbor, MI, USA. 2. 2 Washington State University College of Nursing, Spokane, WA, USA. 3. 3 University of Washington School of Law, Seattle, WA, USA. 4. 4 MedStar Health Research Institute; Hyattsville, MD, USA; Georgetown University School of Medicine, Washington, D.C., USA. 5. 5 University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
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.
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.
Entities:
Keywords:
American Indians; access to care; diabetes; health services; rural aging
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