Minority Health Archive

Who Is at Greatest Risk for Receiving Poor-Quality Health Care?

Asch, Steven M. and Kerr, Eve A. and Keesey, Joan and Adams, John L. and Setodji, Claude M. and Malik, Shaista and McGlynn, Elizabeth A. RAND Health, Santa Monica, California (2006) Who Is at Greatest Risk for Receiving Poor-Quality Health Care? New England Journal of Medicine, 354 (11). pp. 1147-1156.

Full text not available from this repository.

Abstract

Background American adults frequently do not receive recommended health care. The extent to which the quality of health care varies among sociodemographic groups is unknown. Methods We used data from medical records and telephone interviews of a random sample of people living in 12 communities to assess the quality of care received by those who had made at least one visit to a health care provider during the previous two years. We constructed aggregate scores from 439 indicators of the quality of care for 30 chronic and acute conditions and for disease prevention. We estimated the rates at which members of different sociodemographic subgroups received recommended care, with adjustment for the number of chronic and acute conditions, use of health care services, and other sociodemographic characteristics. Results Overall, participants received 54.9 percent of recommended care. Even after adjustment, there was only moderate variation in quality-of-care scores among sociodemographic subgroups. Women had higher overall scores than men (56.6 percent vs.52.3 percent, P<0.001), and participants below the age of 31 years had higher scores than those over the age of 64 years (57.5 percent vs. 52.1 percent, P<0.001). Blacks (57.6 percent) and Hispanics (57.5 percent) had slightly higher scores than whites (54.1 percent, P<0.001 for both comparisons). Those with annual household incomes over $50,000 had higher scores than those with incomes of less than $15,000 (56.6 percent vs. 53.1 percent, P<0.001). Conclusions The differences among sociodemographic subgroups in the observed quality of health care are small in comparison with the gap for each subgroup between observed and desirable quality of health care. Quality-improvement programs that focus solely on reducing disparities among sociodemographic subgroups may miss larger opportunities to improve care.


Export/Citation:EndNote | BibTeX | Dublin Core | ASCII (Chicago style) | HTML Citation | OpenURL | Reference Manager
Social Networking:

Item Type: Article
Uncontrolled Keywords: Health Care, underserved populations, racial differences in care, Ethnic Minorities, Quality of Health Care
Subjects: Health > Health Equity > Access To Healthcare
Health > Disparities
Practice > interventions
Research > studies
Related URLs:
Depositing User: Users 24 not found.
Date Deposited: 05 Apr 2011
Last Modified: 25 May 2011 11:02
Link to this item (URI): http://health-equity.lib.umd.edu/id/eprint/407

Actions (login required)

View Item