Community design of the Brooklyn Health Equity Index

Area of Science:

• Health Services Research
• Patient-Reported Outcomes
• Health Equity

Background:

• Quality healthcare is intrinsically linked to health equity.
• Existing metrics often fail to capture patient perspectives on health equity.
• Central Brooklyn faces significant health disparities, making it a critical area for study.

Purpose of the Study:

• To develop and validate a patient-centered metric to assess health systems' progress in advancing health equity.
• To create a reliable tool for measuring patient perceptions of healthcare inequities.
• To establish a measure for health systems and payers to monitor health equity initiatives.

Main Methods:

• A community-engaged, sequential, mixed-methods research design was employed.
• Qualitative interviews with 80 stakeholders informed initial question development.
• Psychometric testing, including reliability and factor analysis, was conducted on data from 368 patients.

Main Results:

• Qualitative analysis yielded 11 draft questions across trust, social determinants of health, and discrimination domains.
• Psychometric evaluation led to a refined 10-item index, the Brooklyn Health Equity Index (BKHI).
• The BKHI demonstrated good reliability with a Cronbach's alpha of 0.774.

Conclusions:

• The 10-item BKHI is a novel, brief, and reliable measure of patient-perceived health inequities.
• This index provides a real-time tool for health systems and payers to monitor advancements in health equity.
• The BKHI can guide targeted interventions to improve healthcare quality and reduce disparities.