通过有针对性的质量改进实现健康差距的持续缩小：一项三年干预措施的一年随访
Sustained Reduction in Health Disparities Achieved through Targeted Quality Improvement: One-Year Follow-up on a Three-Year Intervention.
作者信息
Balicer Ran D, Hoshen Moshe, Cohen-Stavi Chandra, Shohat-Spitzer Sivan, Kay Calanit, Bitterman Haim, Lieberman Nicky, Jacobson Orit, Shadmi Efrat
机构信息
Clalit Health Services, Tel Aviv, Israel.
Clalit Research Institute, Chief Physician's Office in Clalit Health Services, Tel Aviv, Israel.
出版信息
Health Serv Res. 2015 Dec;50(6):1891-909. doi: 10.1111/1475-6773.12300. Epub 2015 Mar 19.
OBJECTIVE
To assess a quality improvement disparity reduction intervention and its sustainability.
DATA SOURCES/STUDY SETTING: Electronic health records and Quality Index database of Clalit Health Services in Israel (2008-2012).
STUDY DESIGN
Interrupted time-series with pre-, during, and postintervention disparities measurement between 55 target clinics (serving approximately 400,000 mostly low socioeconomic, minority populations) and all other (126) clinics.
DATA COLLECTION/EXTRACTION METHODS: Data on a Quality Indicator Disparity Scale (QUIDS-7) of 7 indicators, and on a 61-indicator scale (QUIDS-61).
PRINCIPAL FINDINGS
The gap between intervention and nonintervention clinics for QUIDS-7 decreased by 66.7 percent and by 70.4 percent for QUIDS-61. Disparity reduction continued (18.2 percent) during the follow-up period.
CONCLUSIONS
Quality improvement can achieve significant reduction in disparities in a wide range of clinical domains, which can be sustained over time.
目的
评估一项质量改进差距缩小干预措施及其可持续性。
数据来源/研究背景：以色列克拉利特医疗服务机构的电子健康记录和质量指数数据库（2008 - 2012年）。
研究设计
对55家目标诊所（服务约40万主要为社会经济地位较低的少数族裔人群）和所有其他（126家）诊所进行干预前、干预期间和干预后的差距测量的中断时间序列分析。
数据收集/提取方法：关于7项指标的质量指标差距量表（QUIDS - 7）以及关于61项指标的量表（QUIDS - 61）的数据。
主要发现
干预诊所与非干预诊所在QUIDS - 7方面的差距下降了66.7%，在QUIDS - 61方面下降了70.4%。在随访期间，差距缩小持续存在（18.2%）。
结论
质量改进能够在广泛的临床领域显著缩小差距，且这种缩小可长期持续。
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