Table 2.
Trends in Clinical Performance Within the Indian Health Service
| 2002 | 2003 | 2004 | 2005 | 2006 | p† | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| N* | % | N* | % | N* | % | N* | % | N* | % | ||
| Preventive services | |||||||||||
| Breast cancer screening | 21,652 | 44% | 22,812 | 42% | 23,965 | 40% | 25,057 | 39% | 26,073 | 40% | 0.002 |
| Influenza vaccination | 26,020 | 53% | 26,821 | 54% | 27,809 | 58% | 29,084 | 65% | 30,222 | 62% | <0.001 |
| Pneumococcal vaccination | 26,020 | 68% | 26,821 | 71% | 27,809 | 74% | 29,084 | 77% | 30,222 | 80% | <0.001 |
| Cholesterol screening | 153,975 | 49% | 158,641 | 53% | 163,843 | 55% | 169,065 | 58% | 172,196 | 61% | <0.001 |
| Diabetes care | |||||||||||
| Retinopathy screening | 40,232 | 51% | 42,718 | 51% | 45,503 | 50% | 47,704 | 51% | 49,513 | 51% | 0.93 |
| HbA1c testing | 74% | 77% | 80% | 80% | 81% | <0.001 | |||||
| LDL cholesterol testing | 46% | 51% | 55% | 58% | 63% | <0.001 | |||||
| HbA1c <7% | 20% | 23% | 25% | 28% | 29% | <0.001 | |||||
| LDL cholesterol <100 mg/dl | 20% | 24% | 26% | 30% | 34% | <0.001 | |||||
| BP <130/80 mmHg | 35% | 36% | 37% | 38% | 39% | <0.001 | |||||
| Cardiovascular disease | |||||||||||
| LDL cholesterol testing | 6,513 | 50% | 7,209 | 54% | 7,941 | 59% | 8,437 | 61% | 9,524 | 64% | <0.001 |
| LDL cholesterol <100 mg/dl | 25% | 28% | 30% | 34% | 37% | <0.001 | |||||
*Number of patients eligible for each measure during each measurement year
†p value for 5 year trend adjusted for clustering of patients within sites