Abstract

The Central Valley of California has a rate of diabetes that is higher than the national average. Patients who have been diagnosed with diabetes must maintain blood sugar levels within a set range to avoid complications. There are a variety of methods used to analyze and control sugar levels, but the Hemoglobin A1c (HbA1c) analysis is the gold standard and should be completed a minimum of two times annually according to the American Diabetes Association. However, not all patients are able to report to their doctor’s office in order to take this test with the requisite frequency. As a substantial agricultural area with a large population of migrant workers, California’s Central Valley has a wide array of unique healthcare barriers that may interfere with a patient’s ability to get routine HbA1c testing. Current studies are lacking data from rural areas such as the California Central Valley, where clinics can be far and few between. 

Despite all these barriers that make it more difficult for patients to maintain their regularly scheduled office visits, the Adventist Healthcare System of the Central Valley has less than a 10% no-show rate. This study found this low truancy rate to be due to a rigorous system for contacting and following up with diabetic patients and the emphasis placed on building strong rapport with patients.