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 thro