Some Federal Government Efforts To Improve Health Disparities Among Minorities, Underserved Effective; Still Room for Improvement, Study Finds
The Health Resources and Services Administration's Health Disparities Collaboratives -- which aims to reduce health care disparities among racial and ethnic minorities and other individuals considered to be underserved -- have been successful in addressing some chronic diseases among those populations, according to a report in this week's New England Journal of Medicine, HealthDay/Washington Post reports. Participating health centers test and implement quality-improvement techniques that were developed by the Institute for Healthcare Improvement. For the report, Bruce Landon, associate professor of health care policy and medicine at Harvard Medical School, and colleagues tracked outcomes for 9,658 patients at 44 community health centers participating in the program and compared results with 20 centers that are not a part of the program. They examined interventions to improve diabetes, asthma and hypertension. According to the study, clinics participating in the program showed improvements in screening and disease prevention among patients with diabetes and asthma, including a 21% increase in foot examinations for people with diabetes and a 14% increase in the use of anti-inflammatory drugs for asthma patients. There also was a 16% increase in diagnostic testing for blood glucose among clinics participating in the program. The clinics, however, did not improve in "intermediate outcomes," such as patients' need for urgent care or hospitalization. In addition, researchers found no improvements in hypertension intervention and maintenance. Landon said, "We were looking for evidence of effectiveness of quality improvement, and this provides evidence that these types of techniques can certainly yield at least moderate improvements for these important chronic medical conditions." Rodney Hayward -- director of health services research and development at the Veteran Affairs Ann Arbor Healthcare System and a professor of medicine and public health at the University of Michigan, who wrote an editorial accompanying the report -- said, "The study shows us how hard it is to achieve real high levels on some of these quality measures," adding, "We have to better understand some of the reasons we're not at the level we wish to be" (Gardner, HealthDay/Washington Post, 2/28).
The report is available online. The editorial also is available online.