Addressing Health Disparities: Case Study

Community Health 349

Article Review 1 "Challenges to Using a Business Case for Addressing Health Disparities"

The major points concerning the challenges to using a business case for addressing health disparities begins with the challenge of quantifying both the business case and the social case for addressing disparities. Sound business and quality improvement principles can guide health care organizations seeking to reduce disparities. Interventions may help focus resources and engage health care and community partners who can share in the costs of, and the gains from such efforts. Racial and ethnic problems when it comes to health and health care interventions is one health disparity. In the health care system the lack of proper data on race and ethnicity has become a problem in the quality of care. Self reported data can take years and requires changes to an already complex infrastructure. However some health plans and hospitals started collecting their own race/ethnicity data and have detected disparities. This has seriously delayed the developement of interventions. Information is not properly obtained, therefore there is no
real way to figure out optimal ways to address such disparities. Ultimately the population affected by this disparity are the minorities in disadvantaged neighborhoods. Information about what works when considering the costs to measure positive Return on Investment (ROI) is difficult.
Information on what works is slow to obtain. Once the disparities in quality are documented we still lack the tools to estimate what it takes to reduce the disparities. No for certain evidence exists that improving quality, regardless of the disparities, generate a positive Return of Investment (ROI). In recent studies evidence was found of a positive Return on Investment (ROI) for intervention to better improve the quality for some diseases (Congestive Heart Failure) evidence for a positive Return on Investment (ROI) for bettering quality care for other conditions is
mixed. A combination of business and quality improvement principles can help guide health care organizations trying to reduce disparities. One way that is suggested is the using Pareto charts and the 80/20 rule, that 80% of the problem arises from 20% of patients, then they can begin to target scarce resources for effectively. Another targeting intervention opportunity can be improved by using using Geographic Information System (GIS). These tools can help to highlight and map out areas of poor quality as small as the census-tract level. A stronger use of collecting data on race and ethnicity will need to improve when considering the challenges of these disparities when quality improvement efforts and effective interventions and supporting infrastructure are developed. Addressing disparities can be helpful by changes within and external to the larger Health Care System. At each level, the individual, Health Care System, employer, and societal levels, that better align incentives, regulations, and interests of stakeholders in ways that promote elimination of disparities and improve equity with other key aims laid out by the Institute of Medicine (IOM).

Work Cited
Health Affairs 27, no.2 (2008): 334-338; 10.1377/hlthaff.27.2.334
National Health Plan Collaborative, Reducing Racial and Ethnic Disparities and Improving Quality of Health Care, November 2006, http://www.chcs.org/NationalHealthPlanCollaborative