Sustained Reduction in Health Disparities Achieved through Targeted Quality Improvement: One-Year Follow-up on a Three-Year Intervention

Ran D. Balicer, Moshe Hoshen, Chandra Cohen-Stavi, Sivan Shohat-Spitzer, Calanit Kay, Haim Bitterman, Nicky Lieberman, Orit Jacobson, Efrat Shadmi

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

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.

Original languageEnglish
Pages (from-to)1891-1909
Number of pages19
JournalHealth Services Research
Volume50
Issue number6
DOIs
StatePublished - 1 Dec 2015
Externally publishedYes

Keywords

  • Health disparities
  • intervention
  • quality improvement

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