Sustained Reduction in Health Disparities Achieved through Targeted Quality Improvement: One-Year Follow-up on a Three-Year Intervention.
Health Services Research Journal, 2015. 50(6): p. 1891-909.
Balicer RD, Hoshen M, Cohen-Stavi C, Shohat-Spitzer S, Kay C, Bitterman H, Lieberman N, Jacobson O, Shadmi E.
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.