Sustained Reduction in Health Disparities Achieved through Targeted Quality Improvement: One‐Year Follow‐up on a Three‐Year Intervention

Abstract

OBJECTIVE: To assess a quality improvement disparity reduction intervention and its sustainability. DATA SOURCES/STUDY SETTING: Electronic health records and Quality Index database of Clalit Health Services in Israel (2008-2012). STUDY DESIGN: Interrupted time-series with pre-, during, and postintervention disparities measurement between 55 target clinics (serving approximately 400,000 mostly low socioeconomic, minority populations) and all other (126) clinics. DATA COLLECTION/EXTRACTION METHODS: Data on a Quality Indicator Disparity Scale (QUIDS-7) of 7 indicators, and on a 61-indicator scale (QUIDS-61). PRINCIPAL FINDINGS: The gap between intervention and nonintervention clinics for QUIDS-7 decreased by 66.7 percent and by 70.4 percent for QUIDS-61. Disparity reduction continued (18.2 percent) during the follow-up period. CONCLUSIONS: Quality improvement can achieve significant reduction in disparities in a wide range of clinical domains, which can be sustained over time.