Eliminating disparities in healthcare through quality improvement

Abstract

This chapter discusses the role of quality improvement (QI) as a vehicle for eliminating racial and ethnic disparities in healthcare. Disparities in health and disparities healthcare are not synonymous. The latter represents only one of many contributors to disparities in health. Furthermore, healthcare disparities result from a complex constellation of patient, provider, organizational, and community/societal factors. Tackling inequities in healthcare requires addressing the predominant cause of a particular healthcare disparity. This can be done through well-designed QI interventions. Such interventions can potentially reduce healthcare disparities through either targeted or universally applied strategies. The former specifically targets minority patients within a healthcare organization or targets organizations that serve largely minority patients. The latter applies QI activities to all patients in the expectation that the intervention disproportionately benefits minorities. A range of QI tools exist to improve care to minorities. Review of available evidence shows that it is possible to reduce, if not eliminate, disparities in healthcare using these tools. However, doing so requires a concerted commitment on the part of health plans and insurance payers to adequately finance such efforts. © 2007 Humana Press Inc.