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Sustained Reduction in Health Disparities Achieved through Targeted Quality Improvement: One-Year Follow-up on a
Ran D Balicer1, Moshe Hoshen2, Chandra Cohen-Stavi2
1Clalit Health Services, Tel Aviv, Israel.
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.
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