Factors influencing the effectiveness of interventions to reduce racial and ethnic disparities in health care

• Published in: Social science & medicine (1982) Vol. 70; no. 3; pp. 337 - 341
• Main Authors: Jones, Rhys G., Trivedi, Amal N., Ayanian, John Z.
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-02-2010; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Access to health care; Biological and medical sciences; Cardiovascular Diseases - ethnology; Cardiovascular Diseases - therapy; Chronic disease care; Chronic Illness; Cultural differences; Delivery of Health Care - organization & administration; Diabetes Mellitus - ethnology; Diabetes Mellitus - therapy; Diseases; Effectiveness; Ethnicity; Evidence-Based Medicine; Health care; Health care disparities; Health Care Services; Health inequality; Health policy; Healthcare Disparities; Humans; Inequality; Intervention; Interventions; Interviews as Topic; Medical sciences; Medical treatment; Minority Groups; Miscellaneous; Organizational case studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Qualitative Research; Quality Assurance, Health Care; Quality improvement; Race; Racial differences; Racial differentiation; U.S.A; United States; USA; USA Health care disparities Quality improvement Chronic disease care Organizational case studies Race Ethnicity Interventions; United States; North America; America; United States > US; USA; Quality improvement; Ethnicity; Interventions; Chronic disease care; Race; Health care disparities; Organizational case studies; Human; Ethnic origin; Social Inequality; Chronic disease; Ethnic group; Care; Case study; Improvement; Chronic; Efficiency; Quality; Social medicine; Disparity; Public health
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2009.10.030

Reducing racial and ethnic disparities in health care has become an important policy goal in the United States and other countries, but evidence to inform interventions to address disparities is limited. The objective of this study was to identify important dimensions of interventions to reduce health care disparities. We used qualitative research methods to examine interventions aimed at improving diabetes and/or cardiovascular care for patients from racial and ethnic minority groups within five health care organizations. We interviewed 36 key informants and conducted a thematic analysis to identify important features of these interventions. Key elements of interventions included two contextual factors (external accountability and alignment of incentives to reduce disparities) and four factors related to the organization or intervention itself (organizational commitment, population health focus, use of data to inform solutions, and a comprehensive approach to quality). Consideration of these elements could improve the design, implementation, and evaluation of future interventions to address racial and ethnic disparities in health care.