Strategies for Improving Minority Healthcare Quality. Evidence Report/Technology Assessment Number 90

摘要

In recent years, it has become clear that the healthcare system in the United States is not the same quality of care for ethnic minority populations that is does for the majority white population. Racial and ethnic disparities in access to and quality of healthcare have been extensively documented. The Institute of Medicine report Unequal Treatment confirmed that racial and ethnic disparities in healthcare are not entirely explained by differences in access, clinical appropriateness, or patient preferences. There is also increasing evidence that provider behaviors and practice patterns contribute to disparities in care. Despite extensive documentation of inequities in healthcare quality, little is known about strategies with the potential to improve the quality of healthcare for ethnic minority populations. This report systematically reviews the evidence to determine the effectiveness of interventions designed to improve the quality of healthcare and/or to reduce disparities for ethnic minorities. It focuses on evaluations of interventions aimed at healthcare providers or organizations, as recent work suggests these factors contribute substantially to the inequities. Researchers examined broadly any type of strategy aimed at improving the quality of care in an ethnic minority population of patients, and then looked more specifically at strategies designed to improve the cultural competence of healthcare providers or organizations.