Andrew C. Anderson is an RWJF health policy research scholar at the University of Maryland, College Park, and a senior director at the National Quality Forum, in Washington, D.C.
Erin O'Rourke is a senior director at the National Quality Forum.
Health Aff (Millwood). 2018 Mar;37(3):371-377. doi: 10.1377/hlthaff.2017.1301.
Current approaches to health care quality have failed to reduce health care disparities. Despite dramatic increases in the use of quality measurement and associated payment policies, there has been no notable implementation of measurement strategies to reduce health disparities. The National Quality Forum developed a road map to demonstrate how measurement and associated policies can contribute to eliminating disparities and promote health equity. Specifically, the road map presents a four-part strategy whose components are identifying and prioritizing areas to reduce health disparities, implementing evidence-based interventions to reduce disparities, investing in the development and use of health equity performance measures, and incentivizing the reduction of health disparities and achievement of health equity. To demonstrate how the road map can be applied, we present an example of how measurement and value-based payment can be used to reduce racial disparities in hypertension among African Americans.
目前的医疗质量方法未能减少医疗保健方面的差异。尽管在使用质量衡量标准和相关支付政策方面有了显著增加,但在实施旨在减少健康差异的衡量策略方面却没有明显进展。国家质量论坛制定了路线图,以展示衡量标准和相关政策如何有助于消除差异并促进健康公平。具体而言,路线图提出了一个四部分策略,其组成部分是确定和优先考虑减少健康差异的领域,实施循证干预措施以减少差异,投资开发和使用健康公平绩效衡量标准,并激励减少健康差异和实现健康公平。为了展示路线图的应用方式,我们提供了一个如何使用衡量和基于价值的支付来减少非裔美国人高血压中的种族差异的示例。