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Health Serv Res. 2015 Dec;50(6):1891-909. doi: 10.1111/1475-6773.12300. Epub 2015 Mar 19.

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

Author information

1
Clalit Health Services, Tel Aviv, Israel.
2
Clalit Research Institute, Chief Physician's Office in Clalit Health Services, Tel Aviv, Israel.
3
Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
4
Community Health Division, Clalit Health Services, Tel Aviv, Israel.
5
The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel.

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.

KEYWORDS:

Health disparities; intervention; quality improvement

PMID:
25787874
PMCID:
PMC4693854
DOI:
10.1111/1475-6773.12300
[Indexed for MEDLINE]
Free PMC Article

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