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本文引用的文献

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Adjusting Performance Measures to Ensure Equitable Plan Comparisons.调整绩效指标以确保公平的计划比较。
Health Care Financ Rev. 2001 Spring;22(3):109-126.
2
Reporting CAHPS and HEDIS data by race/ethnicity for Medicare beneficiaries.报告医疗保险受益人的 CAHPS 和 HEDIS 数据按种族/族裔划分。
Health Serv Res. 2013 Apr;48(2 Pt 1):417-34. doi: 10.1111/j.1475-6773.2012.01452.x. Epub 2012 Aug 2.
3
Can hospital cultural competency reduce disparities in patient experiences with care?医院的文化能力能否减少患者在医疗体验方面的差异？
Med Care. 2012 Nov;50 Suppl(0):S48-55. doi: 10.1097/MLR.0b013e3182610ad1.
4
Racial/ethnic disparities in Medicare Part D experiences.医疗保险计划 D 部分的种族/民族差异。
Med Care. 2012 Nov;50 Suppl(Suppl):S40-7. doi: 10.1097/MLR.0b013e3182610aa5.
5
Understanding ethnic and other socio-demographic differences in patient experience of primary care: evidence from the English General Practice Patient Survey.了解初级保健中患者体验的种族和其他社会人口学差异：来自英国全科医生患者调查的证据。
BMJ Qual Saf. 2012 Jan;21(1):21-9. doi: 10.1136/bmjqs-2011-000088. Epub 2011 Sep 7.
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Enhancing the cultural competency of health-care organizations.提高医疗保健机构的文化能力。
Adv Health Care Manag. 2011;10:43-67. doi: 10.1108/s1474-8231(2011)0000010009.
7
How do the experiences of Medicare beneficiary subgroups differ between managed care and original Medicare?医疗保险受益人群亚组在管理式医疗和原始医疗保险之间的体验有何不同？
Health Serv Res. 2011 Aug;46(4):1039-58. doi: 10.1111/j.1475-6773.2011.01245.x. Epub 2011 Feb 9.
8
Racial/ethnic differences in patients' perceptions of inpatient care using the HCAHPS survey.患者对 HCAHPS 调查中住院护理的看法存在种族/民族差异。
Med Care Res Rev. 2010 Feb;67(1):74-92. doi: 10.1177/1077558709341066. Epub 2009 Aug 3.
9
Psychometric properties of an instrument to assess Medicare beneficiaries' prescription drug plan experiences.一种用于评估医疗保险受益人的处方药计划体验的工具的心理测量特性。
Health Care Financ Rev. 2009 Spring;30(3):41-53.
10
Reports and ratings of care: black and white Medicare enrollees.医疗护理报告与评级：黑人和白人医疗保险参保者
J Health Care Poor Underserved. 2008 Nov;19(4):1136-47. doi: 10.1353/hpu.0.0074.

医疗保险计划中的质量和患者体验方面的种族/族裔差异是否在不同指标和种族/族裔群体中普遍存在？

Do Racial/Ethnic Disparities in Quality and Patient Experience within Medicare Plans Generalize across Measures and Racial/Ethnic Groups?

作者信息

Weech-Maldonado Robert, Elliott Marc N, Adams John L, Haviland Amelia M, Klein David J, Hambarsoomian Katrin, Edwards Carol, Dembosky Jacob W, Gaillot Sarah

机构信息

Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL.

RAND Corporation, Santa Monica, CA.

出版信息

Health Serv Res. 2015 Dec;50(6):1829-49. doi: 10.1111/1475-6773.12297. Epub 2015 Mar 11.

DOI:10.1111/1475-6773.12297
PMID:25757356
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4693842/
Abstract

OBJECTIVE

To examine how similar racial/ethnic disparities in clinical quality (Healthcare Effectiveness Data and Information Set [HEDIS]) and patient experience (Consumer Assessment of Healthcare Providers and Systems [CAHPS]) measures are for different measures within Medicare Advantage (MA) plans.

DATA SOURCES/STUDY SETTING: 5.7 million/492,495 MA beneficiaries with 2008-2009 HEDIS/CAHPS data.

STUDY DESIGN

Binomial (HEDIS) and linear (CAHPS) hierarchical mixed models generated contract estimates for HEDIS/CAHPS measures for Hispanics, blacks, Asian-Pacific Islanders, and whites. We examine the correlation of within-plan disparities for HEDIS and CAHPS measures across measures.

PRINCIPAL FINDINGS

Plans with disparities for a given minority group (vs. whites) for a particular measure have a moderate tendency for similar disparities for other measures of the same type (mean r = 0.51/.21 and 53/34 percent positive and statistically significant for CAHPS/HEDIS). This pattern holds to a lesser extent for correlations of CAHPS disparities and HEDIS disparities (mean r = 0.05/0.14/0.23 and 4.4/5.6/4.4 percent) positive and statistically significant for blacks/Hispanics/API.

CONCLUSIONS

Similarities in CAHPS and HEDIS disparities across measures might reflect common structural factors, such as language services or provider incentives, affecting several measures simultaneously. Health plan structural changes might reduce disparities across multiple measures.

摘要

目的

研究在医疗保险优势（MA）计划中，不同种族/族裔在临床质量（医疗保健有效性数据和信息集[HEDIS]）和患者体验（医疗服务提供者和系统消费者评估[CAHPS]）指标方面的差异有多大相似性。

数据来源/研究背景：拥有2008 - 2009年HEDIS/CAHPS数据的570万/492,495名MA受益患者。

研究设计

二项式（HEDIS）和线性（CAHPS）分层混合模型生成了西班牙裔、黑人、亚太岛民和白人在HEDIS/CAHPS指标方面的合同估计值。我们研究了不同指标间HEDIS和CAHPS指标在计划内差异的相关性。

主要发现

对于特定少数群体（与白人相比）在某一特定指标上存在差异的计划，在同一类型的其他指标上存在类似差异的倾向较为适中（CAHPS/HEDIS的平均r值分别为0.51/.21和53/34%为正向且具有统计学意义）。对于CAHPS差异和HEDIS差异的相关性，这种模式在较小程度上成立（黑人/西班牙裔/亚太岛民的平均r值分别为0.05/0.14/0.23以及4.4/5.6/4.4%）为正向且具有统计学意义。

结论

不同指标间CAHPS和HEDIS差异的相似性可能反映了共同的结构因素，如语言服务或提供者激励措施，这些因素会同时影响多个指标。健康计划的结构变化可能会减少多个指标间的差异。