Objectives: To evaluate the role of primary care healthcare delivery on survival for American
Indian patients with diabetes in the southwest United States.
Methods: Data from patients with diabetes admitted to Gallup Indian Medical Center between
2009 and 2016 were analyzed using a log-rank test and Cox Proportional Hazards analyses.
Results: Of the 2661 patients included in analysis, 286 patients died during the study period.
Having visited a primary care provider in the year prior to first admission of the study period
was protective against all-cause mortality in unadjusted analysis (HR (95% CI) = 0.47 (0.31,
0.73)), and after adjustment. The log-rank test indicated there is a significant difference
in overall survival by primary care engagement history prior to admission (p < 0.001). The
median survival time for patients who had seen a primary care provider was 2322 days
versus 2158 days for those who had not seen a primary care provider.
Conclusions: Compared with those who did not see a primary care provider in the year prior
to admission, having seen a primary care provider was associated with improved survival
King et al.
Elsevier Ltd. on behalf of Primary Care Diabetes Europe