Chassin Mark R, Anderson Rebecca M
Department of Health Policy, Mount Sinai School of Medicine, New York, NY 10029, USA. mchassin@ jointcommission.org
Mt Sinai J Med. 2008 Jan-Feb;75(1):7-12. doi: 10.1002/msj.20012.
Substantial racial and ethnic disparities in health and health care exist in the United States. The Department of Health Policy at the Mount Sinai School of Medicine has developed a strategy for reducing those disparities that builds upon its quality improvement experience. This article discusses the utility of applying quality improvement principles to the development of interventions to eliminate underuse of effective treatments and reduce the disparities that may arise from this quality problem. We present a conceptual model of racial disparities in health and our underuse hypothesis. Parallels between our disparities research strategy and six sigma quality improvement methods are described. Finally, the article provides an example of how we have been able to successfully implement proven-effective health improvement programs in the Harlem community even after grant funding has ended.
美国在健康及医疗保健方面存在显著的种族和族裔差异。西奈山医学院的卫生政策系基于其质量改进经验，制定了一项减少这些差异的策略。本文讨论了将质量改进原则应用于开发干预措施以消除有效治疗方法使用不足的情况，并减少可能由此质量问题产生的差异的效用。我们提出了一个健康方面种族差异的概念模型以及我们的使用不足假设。描述了我们的差异研究策略与六西格玛质量改进方法之间的相似之处。最后，本文提供了一个示例，说明即使在拨款资金结束后，我们如何能够在哈莱姆社区成功实施经证实有效的健康改善项目。
