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: Diabetes
Diabetes affects many American Indians and Alaska Natives (AI/AN). In fact, between 1997 and 2003, the number of AI/AN patients who have diabetes and get their health care from IHS increased by 41%. The high costs of health care along with more patients getting diabetes represent a challenge for IHS.

Between the years of 2002 and 2004, the number of deaths from diabetes in the AI/AN population was almost 3 times higher than all other races.

Patients who have diabetes also are more likely to have heart disease (Cardiovascular Disease), which affects the heart and blood vessels. Heart disease is the number one cause of death for AI/AN patients. It is very important for patients who have diabetes to take care of themselves. You can do this by getting the tests you need. The tests will show how well diabetes is being controlled. Blood pressure is one of the tests.

What is a blood pressure test?
Blood pressure is the force of blood against the walls of arteries. Your blood pressure is measured by using two numbers separated by a line, for example 140/90 mmHg. The top number is called the systolic (sis-tol-ic). The bottom number is called the diastolic (dy-a-stol-ic). When these numbers are higher than they should be, it is called high blood pressure.

Who should get this test?
It is important for people with diabetes to have this test done once a year or more.

Why are blood pressure levels important?
Having ideal blood pressure control can:

  • Reduce the chance of having complications from diabetes
  • Lower the chance of heart disease or strokes
  • Cut the chance of having a heart attack when you also eat healthier, exercise, and take medications as ordered by your doctor
  • Lower the chance by one-third of going blind, getting kidney damage and dialysis, and getting nerve damage which can cause amputations

What is a good blood pressure number?
A lower number is a better score.

  • A systolic blood pressure number lower than 130 and a diastolic blood pressure number lower than 80 show you have ideal control.
  • A systolic blood pressure lower than 140 and a diastolic blood pressure number lower than 90 show you have good control, but it could be better.

What is the GPRA measure?
The GPRA measure is the percentage of IHS AI/AN diabetes patients whose most recent blood pressure was lower than 130/80 during the year.

How is IHS doing?
The United States long-term goal is for 57.0% of adults aged 18 years and older diagnosed with diabetes has their blood pressure under control by the year 2020 (Healthy People 2020). The IHS 2012 goal was achieve the rate of 38.7% for the proportion of patients with diagnosed diabetes who have achieved blood pressure control (defined as <130/80). IHS exceeded the goal by reaching 38.9%. The bars on the graph below show that IHS has raised the rate of ideal blood pressure control from 36% in 2002 to 38.9% in 2012. During the same time IHS was providing care to more patients with diabetes. In fact, between 1997 and 2003, the number of AI/AN diabetes patients who received their health care from IHS increased by 41%.

Percentage of IHS AI/AN Patients with Diabetes  with Ideal Blood Pressure Control (< 130/80)  (IHS 2013 goal is to establish a baseline for ideal BP of <140/90)  Note: A higher score is better

View a table of this chart's data.

Year Percent
2002 36
2003 37
2004 35
2005 37
2006 37
2007 39
2008 38
2009 37
2010 38
2011 37.8
2012 38.9
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To see how IHS is doing on this measure at the Area (regional) levels, click here.