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Sustained Reduction in Health Disparities Achieved through Targeted Quality Improvement: One‐Year Follow‐up on a Three‐Year Intervention
Author(s) -
Balicer Ran D.,
Hoshen Moshe,
CohenStavi Chandra,
ShohatSpitzer Sivan,
Kay Calanit,
Bitterman Haim,
Lieberman Nicky,
Jacobson Orit,
Shadmi Efrat
Publication year - 2015
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12300
Subject(s) - medicine , socioeconomic status , quality management , scale (ratio) , intervention (counseling) , data collection , environmental health , gerontology , population , statistics , geography , nursing , service (business) , business , cartography , mathematics , marketing
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.