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Closing the Quality Gap Series: Quality Improvement Interventions to Address Health Disparities

Health care disparities are the difference or gaps in care experience by one population compared to another.  Disparities have been noted in health outcomes, including clinical outcomes such as mortality, process measures in the health care system, and disease prevalence.  By definition, a disparity in health care quality or health outcomes is not due to difference in the health care needs or preferences of the patient but to other factors.  Such differences in health outcomes and their determinants are associated with certain social conditions and demographic attributes.  Despite what is known about disparities, it is not clear what strategies have the potential to improve the quality of care effectively and to reduce inequities for segments of the population.

Quality Improvement (QI) is a multidisciplinary, systems-focused, data-driven method of understanding and improving the efficiency, effectiveness, and reliability of health processes and outcomes of care.  For this report, the Effective Health Care Program defined a QI intervention as a change process in health care systems, services, or suppliers for the purpose of increasing the likelihood of optimal clinical quality of care, measured by positive health outcomes for individuals and populations.  An intervention could also be described as a strategy aimed at reducing the quality gap (the difference between health care processes or outcomes observed in practice and those potentially obtainable based on current evidence-based knowledge) for a group of patients representative of those encountered in routine practice.

This review evaluates the effectiveness of QI interventions in reducing disparities in health and health care.  Two key questions are addressed:

  1. What evidence is available about the effectiveness of quality improvement strategies to reduce differences in health outcomes associated with selected disparities in patients with key conditions?
  2. What evidence is available about the harms related to quality improvement strategies to reduce difference in health outcomes associated with selected disparities in patients with key conditions?

To view the full report from the Agency for Healthcare Research and Quality (AHRQ)’s Effective Health Care Program, visit this site: http://1.usa.gov/PYMxUg

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