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

Abstract

Objective Examine the relationship between healthcare access and diabetes management among a geographically diverse sample of American Indians (AIs) age 50 and older with type 2 diabetes. Method We examined the relationship between access to care and diabetes management, as measured by HbA1c values, using 1998–99 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 values. Results In bivariate analyses, out-of-pocket costs were inversely associated with lower 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.

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