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Quality of Care for Underserved Populations

Quality of Care for Underserved Populations. GIH Phone Conference June 7, 2005. The Fund and Its Mission. Established in 1918 by Anna Harkness Broad charge to “enhance the common good”

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Quality of Care for Underserved Populations

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  1. Quality of Care for Underserved Populations GIH Phone Conference June 7, 2005

  2. The Fund and Its Mission • Established in 1918 by Anna Harkness • Broad charge to “enhance the common good” • Supports efforts to help people live healthy and productive lives, and to assist specific groups with serious and neglected problems • Supports projects on health policy and quality of care

  3. The Commonwealth Fund’s Program & Grant Strategies • Clear program goals • Emphasis on vulnerable populations • Interest it putting the patient first • Scientific research to provide reliable information • Action projects to stimulate adoption of better policies and practices

  4. Quality of Care for Underserved PopulationsProgram Goals To improve quality and reduce disparities in healthcare for low income and racial/ethnic minority patients by • Identifying Problems in Health Care Quality and Their Causes • Developing/Identifying New Practices • Evaluating New Practices • Disseminating Improvements

  5. *Source: Margarita P. Hurtado, Elaine K. Swift, and Janet M. Corrigan, Eds. “Envisioning the National Health Care Quality Report”, National Academy Press, Washington DC, 2001

  6. Quality Challenges for the Underserved Where You Are Who You Are

  7. Quality Challenges for the Underserved Where You Are Quality in Underserved Settings Who You Are Pt Centered Care for the Underserved

  8. Strategic Areas • Promising Models of High Performance Health Systems for the Underserved • Access to High Quality • Quality Monitoring/Data Reporting • Patient Centered Care for the Underserved • Communication • Cultural Competency • Diffusing Best Practices

  9. Quality In Underserved Settings • Goal: To Feature, Evaluate and Diffuse Effective Models of Care in High Performing Health Systems for the Underserved • Strategies: • Describe Variations in Quality Across Health Systems • Identify and Analyze High Performing Health Systems that Care for Low Income and Minority Populations • Identify and Promote Policies that Facilitate High Performance for the Underserved

  10. Data: The Basic Science of Disparities Reduction • Previous Studies • 2001, An assessment of Federal Policies and Practices • Perot/Youdelman • 2002, Developing a Health Plan Report Card • Nerenz • 2004, The Current State of Race, Ethnicity, and Primary Language Data Collection in Hospitals • Hasnain-Wynia • Current Studies • Linking Race and Ethnicity Data with Inpatient Quality-of-Care Measures in Private Hospitals • Hasnain-Wynia • Enhancing the Reporting of Public Hospital Disparities Data • Siegel

  11. Focus on Disparities Across Sites { Person { Place Quality Indicator

  12. People in Minority Communities Have Less Access to Clinical Services Revascularization rates per 100 among patients hospitalized with myocardial infarction^ ^Age-adjusted. Source: Fang J, and Alderman MH. Is Geography Destiny for Patients in New York with Myocardial Infarction? The American Journal of Medicine 2003; 115:448-53.

  13. Patient Centered Care for the Underserved • GOAL: To Improve Patient Experiences in Care for Underserved Populations • Strategies • Develop Measures and Standards • Evidence Base for Effect of Pt Centered Care • Promote Effective Models of Patient Centered Care

  14. Why Measure Cultural Competency? Definition Operationalization/Measurement Measure as an Outcome/Association with Outcomes Incorporate Into QI

  15. Preliminary Work Shows Cultural Competency Improves Quality of Care Preventive medication underuse among children with persistent asthma Cultural Competency Score Source: Lieu TA et al., Cultural Competence Policies and other Predictors of Asthma Care Quality for Medicaid-Insured Children. Pediatrics 114, no. 1 (2003), e102-e110.

  16. Commonwealth Funding Objectives • Focusing projects on public and private policy implications • Evaluating models for dissemination • Partnering or joint-venturing with other foundations, public agencies, business, and health care organizations • Communicating results to health policy officials and health care leaders in a position to affect change in a way that facilitates change

  17. For More Information www.cmwf.org

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