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Related Experiment Video

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Applying the Target Study Conceptual Model to Measure Racial and Ethnic Disparities in Hypertension Treatment

Aster Meche1, Romsai T Boonyasai2,3, Yea-Jen Hsu4

  • 1From the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

Epidemiology (Cambridge, Mass.)
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Summary

This study shows racial disparities in hypertension treatment intensification. After accounting for other factors, Black patients received less treatment intensification than White patients.

Keywords:
Descriptive epidemiologyDisparitiesHealth disparitiesHypertensionInstitute of Medicine

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Area of Science:

  • Health Services Research
  • Clinical Epidemiology
  • Health Disparities Research

Background:

  • Racial and ethnic disparities in healthcare quality persist.
  • The Institute of Medicine (IOM) defines disparity by excluding access, clinical needs, and appropriateness.
  • Measuring these disparities requires robust methodologies.

Purpose of the Study:

  • To demonstrate the application of a conceptual model, the Target Study, for measuring racial disparities in hypertension treatment intensification.
  • To apply the IOM definition of disparity in a real-world healthcare setting.
  • To quantify disparities between Black and White patients.

Main Methods:

  • Utilized a conceptual model (Target Study) to estimate disparities.
  • Emulated a target study using electronic medical record data (2018-2022).
  • Employed inverse probability weighting to adjust for allowable covariates.

Main Results:

  • Unadjusted analysis indicated higher treatment intensification for Black patients.
  • Adjusted analyses revealed consistently lower treatment intensification for Black patients (3-4 percentage points annually).
  • Example: In 2020, adjusted disparity was -3 percentage points (95% CI: -4%, -1%).

Conclusions:

  • The Target Study effectively implements the IOM definition for healthcare disparity measurement.
  • Further research is needed to apply this model across diverse populations.
  • This approach can aid in understanding and addressing health disparities.