Ng Judy H, Tirodkar Manasi A, French Jessica Briefer, Spalt Holly E, Ward Lauren M, Haffer Samuel C, Hewitt Nicole, Rey Dana, Scholle Sarah Hudson
J Health Care Poor Underserved. 2017;28(3):1012-1029. doi: 10.1353/hpu.2017.0093.
Disparities in health care persist among many at-risk groups. This study examines the current state of health quality measures addressing disparities and culturally and linguistically appropriate services (CLAS), and identifies important gaps in existing measures and their implementation.
We searched key quality reporting databases and websites to identify measures and structural program requirements addressing disparities or CLAS. We also conducted a dozen semi-structured interviews to obtain expert perspectives.
Twenty-four measures and eight private or public-sector programs with relevant structural requirements were identified. Half the measures focused on language needs. Few measures were used in national reporting programs and adoption of requirements has been limited. Barriers to implementation included lack of data among health plans, lack of health workforce training, and challenges in defining cultural competence.
Future efforts should seek to enhance implementation of existing quality measures addressing disparities and CLAS, and address barriers to their adoption.
许多高危群体在医疗保健方面仍存在差异。本研究调查了针对差异以及文化和语言适宜服务（CLAS）的健康质量衡量标准的现状，并确定现有衡量标准及其实施方面的重要差距。
我们搜索了关键的质量报告数据库和网站，以确定针对差异或CLAS的衡量标准和结构性项目要求。我们还进行了十二次半结构化访谈，以获取专家观点。
确定了24项衡量标准以及8个有相关结构性要求的私营或公共部门项目。一半的衡量标准关注语言需求。在国家报告项目中很少使用这些衡量标准，要求的采用情况有限。实施障碍包括健康计划中缺乏数据、卫生人力培训不足以及在定义文化能力方面存在挑战。
未来的努力应致力于加强现有针对差异和CLAS的质量衡量标准的实施，并消除采用这些标准的障碍。
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