1. Sustained Reduction in Health Disparities Achieved through Targeted Quality Improvement: One-Year Follow-up on a Three-Year Intervention
- Author
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Sivan Shohat-Spitzer, Haim Bitterman, Orit Jacobson, Chandra J Cohen-Stavi, Calanit Kay, Nicky Lieberman, Efrat Shadmi, Moshe Hoshen, and Ran D. Balicer
- Subjects
Quality management ,One year follow up ,media_common.quotation_subject ,Environmental health ,Intervention (counseling) ,parasitic diseases ,Humans ,Medicine ,Quality (business) ,Healthcare Disparities ,Israel ,Poverty ,Socioeconomic status ,Minority Groups ,Quality Indicators, Health Care ,media_common ,Patient Care Team ,Data collection ,Reducing Disparties Improving Access ,business.industry ,Health Policy ,Interrupted Time Series Analysis ,Health Status Disparities ,Quality Improvement ,Health equity ,Socioeconomic Factors ,Scale (social sciences) ,Health Services Research ,business - 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.
- Published
- 2015
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