Achieving Health Equity in the Community, as well as, the Healthcare System
As we reach the final days of National Minority Health Month, one Healthcare Executive article recently caught my eye.&nbs
As we reach the final days of National Minority Health Month, one Healthcare Executive article recently caught my eye. In John Buell’s, “Equity of Care”, the author stipulates that healthcare systems must focus on six key elements in order to truly achieve quality care. In absence of efficiency, effectiveness, safety, timeliness, patient-centeredness or equity, Buell contends that institutions are not meeting the mark. While progress is being made on the first five ingredients, equity is described as, “the last fundamental piece that many hospitals have struggled to achieve but one with which some clear progress is being made.”
According to the author, “equity is achieved by providing care that does not vary in quality on the basis of patients’ personal characteristics such as ethnicity, gender, geographic location and socioeconomic status.” With the diabetes-related death rate of blacks in the U.S. almost twice that of whites, Dr. Joseph R. Betancourt, Associate Professor of Medicine at Harvard and Director, the Disparities Solutions Center at Massachusetts General Hospital, asserts that social determinants and access to care are the leading contributors to racial and ethnic disparities. Dr. Betancourt also points out that, “hospitals are not purposefully treating patients differently, but it may mean that hospitals are not doing the extra things to meet the needs of the diverse populations.”
So, what can be done to reverse this trend? The Disparities Solutions Center provides the following recommendations:
- Create a disparities committee or task force – multidisciplinary team charged with what is being done to identify and address disparities, including whether or not patients’ race and ethnicity are being collected.
- Build a foundation to address disparities, including data collection and stratification of quality measures
- Develop medical policies
- Finalize a strategic plan with one, three and five year goals
- Assign leadership and raise awareness with internal and external constituencies
- Create a dashboard for monitoring assigned measures and standardize processes
- Develop pilots to address disparities
- Evaluate, share and re-engineer
While not explicitly addressed at this level, it also remains critical to note that a multicultural workforce provides a sense of community for prospective patients and resource for creative recommendations to better serve their brethren. Engaging patients beyond the hospital walls to educate and empower them for better health also holds great promise. With 45% of the fastest growing segment of the population owning smartphones, are we harnessing this engine to effectively reach Hispanics regarding their significant predisposition to diabetes…and the means to avoid it? For that matter, is the U.S. taking serious note of the innovative preventive and service delivery measures that less developed countries are employing? Last but not least, technology is merely an enabler and achieving true equity demands fundamental reassessment of ‘health’ in the community, as well as, the healthcare system.
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