Access to Care and Diabetes Management Among Older American Indians With Type 2 Diabetes

被引：5

作者：

Nicklett, Emily J. ^{[1
]}

Omidpanah, Adam ^{[2
]}

Whitener, Ron ^{[3
]}

Howard, Barbara V. ^{[4
,5
]}

Manson, Spero M. ^{[6
]}

机构：

[1] Univ Michigan, Sch Social Work, 1080 South Univ Ave, Ann Arbor, MI 48109 USA

[2] Washington State Univ, Coll Nursing, Spokane, WA USA

[3] Univ Washington, Sch Law, Seattle, WA 98195 USA

[4] MedStar Hlth Res Inst, Hyattsville, MD USA

[5] Georgetown Univ, Sch Med, Washington, DC USA

[6] Univ Colorado, Anschutz Med Campus, Aurora, CO USA

来源：

JOURNAL OF AGING AND HEALTH | 2017年 / 29卷 / 02期

关键词：

American Indians; diabetes; health services; access to care; rural aging; HEALTH-CARE; DISPARITIES; COMMUNITIES; DISTANCE; OUTCOMES; DETERMINANTS; SURVIVAL;

D O I：

10.1177/0898264316635562

中图分类号：

R4 [临床医学]; R592 [老年病学];

学科分类号：

1002 ; 100203 ; 100602 ;

摘要：

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 HbA(1c), 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 HbA(1c) levels. Results: In bivariate analyses, out-of-pocket costs were associated with higher HbA(1c) 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.

引用

页码：206 / 221

页数：16

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