Sustained Reduction in Health Disparities Achieved through Targeted Quality Improvement: One‐Year Follow‐up on a Three‐Year Intervention. (19th March 2015)

• Record Type: Journal Article
• Authors: Balicer, Ran D.; Hoshen, Moshe; Cohen‐Stavi, Chandra; Shohat‐Spitzer, Sivan; Kay, Calanit; Bitterman, Haim; Lieberman, Nicky; Jacobson, Orit; Shadmi, Efrat
• Is Part Of: Health services research. Volume 50:Number 6(2015)
• Page Start: 1891
• Page End: 1909
• Publication Date: 2015-03-19
• Subjects: Health disparities -- intervention -- quality improvement; Medical care -- Periodicals; Medical care -- Evaluation -- Periodicals; Hospital care -- Periodicals; Health services administration -- Periodicals; 362
• DOI: 10.1111/1475-6773.12300
• Languages: English
• ISSNs: 0017-9124

Abstract

Abstract : Objective: To assess a quality improvement disparity reduction intervention and its sustainability. Data Sources/Study Setting: Electronic health records and Quality Index database of Clalit Health Services in Israel (2008–2012). Study Design: Interrupted time‐series with pre‐, during, and postintervention disparities measurement between 55 target clinics (serving approximately 400, 000 mostly low socioeconomic, minority populations) and all other (126) clinics. Data Collection/Extraction Methods: Data on a Quality Indicator Disparity Scale (QUIDS‐7) of 7 indicators, and on a 61‐indicator scale (QUIDS‐61). Principal Findings: The gap between intervention and nonintervention clinics for QUIDS‐7 decreased by 66.7 percent and by 70.4 percent for QUIDS‐61. Disparity reduction continued (18.2 percent) during the follow‐up period. Conclusions: Quality improvement can achieve significant reduction in disparities in a wide range of clinical domains, which can be sustained over time.