Racial and ethnic disparities in health care quality are well documented in the Institute of Medicine's report,
Unequal Treatment, as well as in the Agency for Healthcare Research and Quality's annual National Healthcare Disparities Report.
(1) (2) While recent findings suggest that some progress has been made in closing the gaps,
(3) significant efforts are still needed to ensure high-quality care for all minority and low-income patients.
One of the strategies of the Underserved Program is to identify and disseminate best practices in safety net hospitals and community health centers, which serve large numbers of racial and ethnic minorities and low-income patients. Although these health systems face challenges due to lack of resources, they have demonstrated the ability to provide high-quality care.
In a Fund-supported study, Marsha Regenstein, Ph.D., and colleagues at the National Public Health and Hospital Institute found that clinical outcomes for public hospital patients with diabetes—many of whom are particularly vulnerable due to low income and lack of health insurance—were comparable to or, in some cases, even better than national averages for all hospitals.
(4) Still, neither public hospitals nor managed care plans performed as well as the Veterans Administration (VA), a public health system that has rigorous protocols for quality improvement. The authors suggest that the VA's success in managing patients with diabetes can serve as a model for delivering high-quality care to underserved patients.
