Wilkes Abigail E, Bordenave Kristine, Vinci Lisa, Peek Monica E
Section of General Internal Medicine at the University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA.
Diabetes Manag (Lond). 2011 Nov;1(6):653-660. doi: 10.2217/dmt.11.48.
A review of national data confirms that while the quality of healthcare in the USA is slowly improving, disparities in diabetes prevalence, processes of care and outcomes for racial/ethnic minorities are not. Many quality measures can be addressed through system level interventions, referred to as quality improvement (QI), and QI collaboratives have been found to effectively improve processes of care for chronic conditions, including diabetes. However, the impact of QI collaboratives on the reduction of health disparities has been mixed. Lessons learned from previous QI collaboratives including the complexity of impacting clinical outcomes, the need for expert support for skills outside of QI methodology, limiting impact of poor data, and the need to develop disparities quality measures, can be used to inform future QI collaborative approaches to reduce diabetes racial/ethnic minority health disparities.
一项对全国数据的审查证实，虽然美国的医疗保健质量正在缓慢改善，但种族/族裔少数群体在糖尿病患病率、护理过程和治疗结果方面的差异却没有改善。许多质量指标可以通过系统层面的干预措施来解决，即所谓的质量改进（QI），并且已经发现QI合作组织能有效改善包括糖尿病在内的慢性病护理过程。然而，QI合作组织对减少健康差距的影响好坏参半。从以前的QI合作组织中吸取的经验教训，包括影响临床结果的复杂性、对QI方法之外的技能需要专家支持、不良数据的限制影响以及制定差距质量指标的必要性，可用于为未来减少糖尿病种族/族裔少数群体健康差距的QI合作方法提供参考。
