Improving Diabetes Care for American Indians
- Kelly Acton, MD,
- Sarah Valway, DMD, MPH,
- Steven Helgerson, MD, MPH,
- James B Huy, BS,
- Kermit Smith, DO,
- Victoria Chapman, DO and
- Dorothy Gohdes, MD
- Public Health Service Indian Health Center, St. Ignatius Montana Division of Tuberculosis Elimination, National Center for Prevention Services, Centers for Disease Control Atlanta, Georgia Billings and Portland Areas, Indian Health Service Epidemiology, Seattle, Washington Indian Health Service Diabetes Program Albuquerque, New Mexico Phoenix Area Indian Health Service Phoenix, Arizona Strong Memorial Hospital Rochester, New York
- Address correspondence and reprint requests to Kelly Acton, MD, Flathead Indian Health Center, PO BOX 280, St. Ignatius, MT 59865.
Abstract
In 1986, a diabetes control program was implemented in the Billings area of the IHS. Baseline health-care practices in the program were described using a structured audit. The program included adoption of the IHS Minimum Standards of Care for diabetes, technical assistance, and professional and patient education. A second audit was performed in 1988. Care practices improved significantly for all facilities in 7 of 10 parameters measured. Facilities that implemented key program activities showed more overall improvement in screening practices, education, and immunization than those that did not organize diabetes care. Factors associated with improved care practices include establishment of a coordinated, multidisciplinary diabetes team with regular meetings, acceptance of standards of care by the medical staff, use of flow sheets by multiple providers, and diabetes-related professional and patient education sessions.
- Copyright © 1993 by the American Diabetes Association
