Thirty Years of Disparities Intervention Research
| Autor: | Nicholas W. Stock, Jaleesa A.S. Akuoko, Amanda R. Clarke, Anna P. Goddu, Robert S. Nocon, Linda Chyr, Marshall H. Chin |
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| Rok vydání: | 2013 |
| Předmět: |
Quality management
Attitude of Health Personnel Decision Making Psychological intervention Context (language use) Article Patient Education as Topic Nursing parasitic diseases Health care Patient Protection and Affordable Care Act Ethnicity Humans Medicine Community Health Services Healthcare Disparities business.industry Communication Racial Groups Public Health Environmental and Occupational Health Health services research Health equity Self Care Patient Compliance Health Services Research business Cultural competence |
| Zdroj: | Medical Care. 51:1020-1026 |
| ISSN: | 0025-7079 |
| Popis: | Over the past 30 years, disparities researchers have shifted focus from documenting racial and ethnic disparities to identifying interventions that close the gap in care.1 The Patient Protection and Affordable Care Act will institutionalize the collection of clinical performance data stratified by race, ethnicity, and language, providing promising opportunities for organizations to identify health disparities in their patient populations.2 However, stratified data alone are insufficient to reduce disparities.3 There remains a critical need for evidence-based interventions that improve outcomes for minority patients.4 Existing reviews of disparities interventions focus on specific diseases, care settings, or priority populations. Several reviews have developed taxonomies of intervention studies to organize their findings; however, to our knowledge, none focus specifically on efforts to improve minority health.5–8 The Agency for Healthcare Research and Quality's Taxonomy of Quality Improvement, for example, does not include equity-specific approaches, such as cultural competency training or enhanced interpreter services.9 It is important to assess the disparities literature specifically, because generic quality improvement efforts are insufficient to close the gap in care.10 Even quality improvement initiatives that improve outcomes for all patients can inadvertently widen the difference in outcomes between White and minority patients.11 Equity-specific approaches that are tailored for minority patients show promise for reducing disparities,12 as do nonclinical services that complement and enhance care delivery for priority populations.1 Therefore, we developed a taxonomy of disparities interventions in the healthcare setting and used this taxonomy to systematically categorize 391 intervention articles from the peer-reviewed literature. Our taxonomy organizes the disparities literature so that researchers, providers, funders, and policymakers can easily identify the available evidence and target areas for further study. It breaks down multi-faceted interventions into their essential parts, guiding healthcare organizations to identify the approaches that best fit their context and settings. The tool also helps patients and patient advocates understand the variety of programs available to them. Overall, the disparities taxonomy allows readers to identify studies relevant to their own work and target approaches for reducing disparities in care. |
| Databáze: | OpenAIRE |
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