TY - JOUR
T1 - Reducing health disparities
T2 - Strategy planning and implementation in Israel's largest health care organization
AU - Balicer, Ran D.
AU - Shadmi, Efrat
AU - Lieberman, Nicky
AU - Greenberg-Dotan, Sari
AU - Goldfracht, Margalit
AU - Jana, Liora
AU - Cohen, Arnon D.
AU - Regev-Rosenberg, Sigal
AU - Jacobson, Orit
PY - 2011/8
Y1 - 2011/8
N2 - Objective: To describe an organization-wide disparity reduction strategy and to assess its success in quality improvement and reduction of gaps in health and health care. Study Setting. Clalit Health Services, Israel's largest non-for-profit insurer and provider serving 3.8 million persons. Study Design. Before and after design: quality assessment before and 12-month postinitiation of the strategic plan. A composite weighted score of seven quality indicators, measuring attainment of diabetes, blood pressure, and lipid control, lack of anemia in infants, and performance of mammography, occult blood tests, and influenza vaccinations. Data Extraction Methods. Quality indicator scores, derived from Clalit's central data warehouse, based on data from electronic medical records. Principal Findings. Low-performing clinics, of low-socioeconomic and minority populations, were targeted for intervention. Twelve months after the initiation of the project continuous improvement was observed coupled with a reduction of 40 percent of the gap between disadvantaged clinics, serving â10 percent of enrollees, and all other medium-large clinics. Conclusion. The comprehensive strategy, following a quality improvement framework, with a top-down top-management incentives and monitoring, and a bottom-up locally tailored interventions, approach, is showing promising results of overall quality improvement coupled with disparity reduction in key health and health care indicators.
AB - Objective: To describe an organization-wide disparity reduction strategy and to assess its success in quality improvement and reduction of gaps in health and health care. Study Setting. Clalit Health Services, Israel's largest non-for-profit insurer and provider serving 3.8 million persons. Study Design. Before and after design: quality assessment before and 12-month postinitiation of the strategic plan. A composite weighted score of seven quality indicators, measuring attainment of diabetes, blood pressure, and lipid control, lack of anemia in infants, and performance of mammography, occult blood tests, and influenza vaccinations. Data Extraction Methods. Quality indicator scores, derived from Clalit's central data warehouse, based on data from electronic medical records. Principal Findings. Low-performing clinics, of low-socioeconomic and minority populations, were targeted for intervention. Twelve months after the initiation of the project continuous improvement was observed coupled with a reduction of 40 percent of the gap between disadvantaged clinics, serving â10 percent of enrollees, and all other medium-large clinics. Conclusion. The comprehensive strategy, following a quality improvement framework, with a top-down top-management incentives and monitoring, and a bottom-up locally tailored interventions, approach, is showing promising results of overall quality improvement coupled with disparity reduction in key health and health care indicators.
KW - Disparities
KW - primary care
KW - quality assessment
KW - quality improvement
UR - http://www.scopus.com/inward/record.url?scp=79960087669&partnerID=8YFLogxK
U2 - 10.1111/j.1475-6773.2011.01247.x
DO - 10.1111/j.1475-6773.2011.01247.x
M3 - Article
C2 - 21352224
AN - SCOPUS:79960087669
SN - 0017-9124
VL - 46
SP - 1281
EP - 1299
JO - Health Services Research
JF - Health Services Research
IS - 4
ER -