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CURRENT RESEARCH AND NEWS
Health Care Disparities Influenced By Where Minorities Seek Care: Study Published in Archives in Internal Medicine
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Where minority patients get health care can influence the quality of care they receive and may be a major underlying cause of health care disparities, according to a study published in the June 25 issue of the Archives of Internal Medicine. Romana Hasnain-Wynia, Ph.D., vice president, research, HRET, was lead author
for “Disparities in Health Care Driven by Where Minority Patients Seek Care: Examination of the Hospital Quality Alliance Measures.” Using patient-level data from 123 hospitals of the University HealthSystem Consortium, the study showed that disparities are largely a result of where minority patients seek care, which has “very important implications for policymakers,”
according to Dr. Hasnain-Wynia.
In the study, researchers found consistent differences between minority and nonminority patients in the quality of care, across 8 of 13 quality measures for acute myocardial infarction, congestive heart failure, community-acquired pneumonia, and patient counseling. This study is the first to use patient-level measures to
assess disparities within and between hospitals. It is also the first to examine racial and ethnic disparities in patient counseling measures, which are thought to be especially sensitive to problems of cross-cultural miscommunication.
According to the study, hospitals that treat a higher percentage of minority patients tend to underperform on many of the quality measures. “The differences in quality between the high performers and the low performers were especially stark when looking at communication-related measures of quality,” according to
Dr. Hasnain-Wynia. “It seems that many minorities are receiving care in hospitals that do not have staffing and other resources needed to provide recommended counseling and prevention messages.”
The study’s findings suggest that minority patients may be more likely to seek care in hospitals with fewer resources. Other studies have shown that these hospitals often face nurse staffing shortages, inadequate budgets, high levels of uninsured patients, lack of technical support, and lack of capital. “When
you combine lack of resources and more disadvantaged patients, even very hardworking, well-trained, and efficient providers are liable to miss some quality targets,” said Mary Pittman, DrPH, president of HRET. “If we want to address the roots of health care disparities, we will have to better understand the resources needed in hospitals that care for a large number of minority
patients,” she said.
Supported by the Commonwealth Fund, the study was conducted by researchers from HRET, Northwestern University’s Feinberg School of Medicine, the Henry Ford Health Systems, the Commonwealth Fund, Harvard Medical School, and the University HealthSystem Consortium.
Click here to read the Archives of Internal Medicine article, “Disparities in Health Care Are Driven by Where Minority Patients Seek Care: Examination of the Hospital Quality Alliance Measures.”
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ACTION Task Order on Asthma in Children Awarded to HRET
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HRET was recently awarded a new ACTION network task order, “Implementing evidence-based quality improvement strategies to improve asthma care for children.” A team from the University of Washington led by Jim Stout will conduct most of the research for this project. The 18-month award is for $299,501. ACTION,
Accelerating Change and Transformation in Organizations and Networks, is a program funded by the Agency for Healthcare Research and Quality (AHRQ). For more information on the ACTION network, click here.
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Janet Corrigan to Present Performance Measures Session at Leadership Summit
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Janet Corrigan, president and CEO of the National Quality Forum and HRET’s 2007 TRUST Award recipient, will facilitate a session entitled “Performance Measurement and Public Reporting: Next Steps,” on Sunday, July 22, at 4:15 p.m. at the Health Forum/AHA Leadership Summit in San Diego. Dr. Corrigan’s
session will provide an overview of the National Quality Forum’s role in setting national priorities and goals for quality improvement and endorsing standardized performance measures. She will describe the types of performance measures in the pipeline that will likely be incorporated into payment programs in the next three to five years and lead a discussion of changes in the health care
delivery system that will be important to achieving expected levels of performance.
“Measuring What Matters Most,” a column authored by Dr. Corrigan in the July issue of Hospitals & Health Networks, also discusses performance measurement and reporting. Click here to read the column.
Dr. Corrigan will receive the HRET 2007 TRUST Award at an evening reception, also on July 22 during the Summit. Established in 2003, the TRUST Award recognizes individuals who exhibit visionary leadership and symbolize HRET’s commitment and desire to rebuild trust within health care organizations and with community
partners. To purchase a reception ticket or learn more about the TRUST Award, click here.
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RECENT ARTICLES AND PUBLICATIONS
Community Benefit Strategy Featured in Spectrum Article
Michael Bilton, executive director of HRET’s Association for Community Health Improvement (ACHI), authored “Community Benefit Is a Vital Part of Healthcare Strategy” for the July/August edition of Spectrum. The article focuses on the need for a well-executed strategy for community benefit in
hospitals and includes ideas on how to create a targeted and evidence-based community benefit program. The Spectrum newsletter is published by the Society for Healthcare Strategy and Market Development (SHSMD). Michael Bilton is also vice president, education, for HRET. For more information on community health, click here.
Public Health Leaders Urged to Continue Work to Prevent Mother-to-Child Transmission of HIV
An article in the July issue of the Journal of Public Health Policy addresses the ongoing need for
attention to perinatal HIV transmission. Coauthored by Frances Margolin, vice president, operations, at HRET, the article discusses how the dramatic reduction of perinatally transmitted HIV in the United States has been a striking success story. Routine HIV screening during pregnancy followed by appropriate therapy has been extremely effective. This paper puts forth three strategies needed to
maintain these gains and reach the goal of eliminating perinatal HIV: standardize medical interventions and policy changes that support perinatal HIV reduction; institute HIV screening in routine preconception care to identify HIV infection in women before pregnancy; and critically focus attention and resources on primary prevention of HIV infection in women. Successful approaches that have nearly
eliminated perinatal HIV transmission in the United States offer valuable lessons that should be applied to primary HIV prevention for women in the United States and globally.
UPCOMING EVENTS AND ANNOUNCEMENTS
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Community Health and Community Benefit Conference Invites Speaker Proposals
HRET’s Association for Community Health Improvement (ACHI) is inviting proposals for breakout sessions for its fifth national conference, taking place March 5-7, 2008, in Atlanta. Drawing more than 450 professional from hospitals, health systems, foundations, public health and community health organizations, the ACHI
annual conference has become the premier gathering for stimulating real change and improvements in how community health programs are planned, run, and evaluated. ACHI is looking for excellent stories of community health improvement initiatives, and for demonstrated outcomes and specific guidance on achievements, which conference attendees can take home to replicate.
Call for sessions is open by clicking here. All proposals are due August 3, 2007. The five topic
tracks include: Minimizing Chronic Disease; Maximizing Coverage; Health Assessments to Health Outcomes; Delivering Community Benefit; and Public Health and Health System Partnerships.
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Online Career Center for Community Health and Community Benefit Positions
ACHI has an online Career Center dedicated specifically to helping hospitals and other organizations find qualified professionals in the specialized roles of community health and community benefit.
The Career Center reaches thousands of professionals who visit ACHI’s Web site specifically because it is a leading resource for hospitals in this niche. Whether you are conducting a targeted recruitment campaign or thinking of a career or job change, click here to view potential job openings or to post your resume. Resume-posting is free, and job listings are discounted for ACHI members
Audioconference Presents Updated Information on Prevention of Perinatal HIV Transmission
In collaboration with the AHA’s Section on Maternal and Child Health, HRET is hosting a free audioconference on Friday, July 20, at 1:00 Eastern time. The session will be repeated on Friday, July 27. A follow-up to a session in the summer of 2004, Margaret Lampe, CDC Division of HIV/AIDS Prevention, Maternal Child
Studies, will provide an update and discussion on progress in prevention of perinatal transmission and CDC’s latest findings and recommendations. Time will be set aside on the one hour call to take questions. For more information or to register, contact Camille Holder at cholder@aha.org.
HRET FELLOWSHIPS
Leadership Fellows Announced for 2007-2008
HRET has selected 47 people to participate in its 2007-08 Patient Safety Leadership (PSL) and Cultural Competence Leadership (CCL) Fellowship programs. The yearlong fellowships connect senior practitioners with national thought leaders and a learning community of peers. Each fellow or team of fellows directs an action
learning project to stimulate change within their organization and put new skills and tools into practice.
All fellows will participate in three face-to-face leadership retreats, the first one scheduled from July 19-24 in San Diego during the AHA/Health Forum Leadership Summit. Throughout the year, fellows also participate in online conferencing, self-study educational curricula, and site visits. For more on the PSL and CCL
Fellowship programs, including a complete list of the new Fellowship classes, click here.
HRET Welcomes Interns
Christian Krautkramer joins HRET in the Chicago office this summer. A dual master’s candidate in medical science and public health at Boston University, Krautkramer previously worked as a senior research assistant in the ethics group at the
American Medical Association. He has authored articles on bioethics and health policy and also has contributed an essay to Food and Philosophy, a book in the recently released Epicurean Trilogy published by Blackwell.
Kevin Van Dyke also joins the Chicago office after graduating in June with a M.P.P. from the Irving B. Harris School of Public Policy Studies at the University of Chicago and a joint-certificate in health administration and policy. He received the George
Bugbee Program Advocacy Award from the university and was a McCormick Tribune Leadership Fellow. Van Dyke previously worked at the University of Chicago Medical Center, and as a teacher and Web editor.
Erin Braddock is an intern for ACHI in the San Francisco office. She is a recent graduate of Stanford University with a B.A. in public policy, a major combining economic analysis, political science, mathematics, and public policy issues. While at
Stanford, Braddock was involved in teaching and mentoring low-income high school students who were preparing for college. She plans to attend law school to study public interest law and focus on tackling health care and educational disparities.
Sandra Heidrich also joins ACHI until October. She recently graduated from the University of California, Berkeley, with a B.A. in development studies, focusing on issues of public health in Latin America and sub-Saharan Africa. After her work with ACHI,
she will spend six months in Mombasa, Kenya, working with a local nongovernmental organization providing resources for orphans and widows affected by HIV/AIDS.
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