U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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  Quality of IHS Health Care

Performance Measures

Health Topic: Cardiovascular Disease
Death rates from heart disease are higher among AI/AN people than other groups. In the late 1990s, heart disease death rates were 20% higher among AI/AN people than the total U.S. population, and stroke death rates were 14% higher. Heart disease represents the leading cause of death for AI/AN people above 45 years of age. Unlike other racial and ethnic groups, American Indians appear to have an increasing rate of cardiovascular disease. This is likely due to the high occurrence of diabetes.

What is a Comprehensive CVD Assessment?
A comprehensive CVD assessment includes all of the following:

  • Blood pressure taken at least twice in the past two years
  • LDL cholesterol completed in the past five years
  • Screened for tobacco use during the year
  • Determined patient's weight status (body mass index [BMI])
  • Counseled patient during the year to encourage changing their nutrition and exercise habits

What is the GPRA measure?
The GPRA measure is the percentage of IHS AI/AN patients ages 22 and older with ischemic heart disease (IHD) who received a comprehensive cardiovascular disease (CVD) assessment.

How is IHS doing?
IHS has not established a long-term goal for this measure. The 2012 IHS goal was to achieve the rate of 40.6% for the proportion of at-risk patients who have a comprehensive assessment. IHS exceeded the goal by reaching 45.4%. The bars on the graph below show that IHS has increased the rate of comprehensive CVD assessment in patients with ischemic heart disease from 30% in 2007 to 45.4% in 2012. However, beginning in 2010 refusals was removed from the rates. So, the 2007-2009 rates cannot be compared with the 2010-2012 rates. Beginning in 2013, this measure will include patients with a Coronary Heart Disease (CHD) diagnosis.

Percentage of IHS AI/AN Patients Ages 22 and Older  with Ischemic Heart Disease  with a Comprehensive CVD Assessment  (IHS 2013 goal is 32.3% for CHD patients ages 22 and older)  NOTE: A higher score is better

View a table of this chart's data.

Year Percent
2007 30
2008 30
2009 32
2010 35
2011 39.8
2012 45.4
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To see how IHS is doing on this measure at the Area (regional) levels, click here.