Trends in Quality of Care and Barriers to Improvement in the Indian Health Service

Clinical care for Native Americans improved in 10 major categories from 2002 to 2006; breast cancer screening is far below the national benchmark.

Because Native Americans experience high rates of chronic disease and mental health disorders, there is a pressing need to improve the federal Indian Health Service (IHS); this study analyzed the quality of care provided by IHS. Researchers surveyed physicians regarding barriers to improving the agency's performance; analyzing data from the IHS national clinical reporting system, focusing on preventive services, diabetes and cardiovascular disease care.

Key Findings:

  • In 2006, IHS provided influenza vaccinations to 62 percent of its patients, up from 53 percent in 2002.
  • A third of all physicians cited a lack of specialist providers nearby as a “very important” barrier to care.

IHS cares for 1.9 million Native Americans, roughly half of the entire Native American population. The findings of this large-scale assessment point to general improvements in care provided through IHS. Still, many more IHS physicians report inadequate access to essential health services than do physicians caring for White and Black Americans.