Reducing Health Disparities Through Research & Translation Programs (Text Version)
On September 20, 2011, Francis Chesley, Jr., M.D. made this presentation at the 2011 Annual Conference. Select to access the PowerPoint® presentation (1.4 MB). .
Slide 1
Reducing Health Disparities Through Research & Translation Programs
Francis D. Chesley, Jr., M.D.
Director, Office of Extramural Research, Education, & Priority Populations
Agency for Healthcare Research and Quality
AHRQ Annual Meeting
September 20, 2011
Slide 2
AHRQ Priorities
Patient Safety
- Health Information Technology (IT).
- Patient Safety Organizations.
- New Patient Safety Grants.
Effective Health Care Program
- Comparative Effectiveness Reviews.
- Comparative Effectiveness Research.
- Clear Findings for Multiple Audiences.
Other Research & Dissemination Activities
- Quality & Cost-Effectiveness, e.g., Prevention and Pharmaceutical Outcomes.
- U.S. Preventive Services Task Force.
- Methicillin-resistant Staphylococcus aureus/Healthcare-associated Infections (MRSA/HAIs).
Medical Expenditure Panel Surveys
- Visit-Level Information on Medical Expenditures.
- Annual Quality & Disparities Reports.
Ambulatory Patient Safety
- Safety & Quality Measures, Drug Management and Patient-Centered Care.
- Patient Safety Improvement Corps.
Slide 3
Health & Health Care Disparities
- Disparities: a meaningful difference between population groups in access or quality of care.
- Racial and ethnic disparities in health and health care are well documents & and worsening in some cases:
- Life expectancy.
- Infant mortality.
- Chronic diseases.
- Quality.
- The U.S. population continues to become more diverse (54% of US population by 2050).
- We know enough to act now.
Slide 4
New: 2010 National Healthcare Quality and Disparities Reports
Reports Indicate that Quality Is Improving, but at a Slow Pace
- Overall, improvement in the quality of care remains suboptimal and access to care is not improving.
- Few disparities in quality are getting smaller and almost no disparities in access are getting smaller.
- Quality of care varies not only across types of care but also across parts of the country.
Slide 5
2010 National Healthcare Disparities Report
Health care quality and access are suboptimal, especially for minority and low-income groups.
- Hispanics received worse care than non-Hispanic Whites for about 60% of core measures.
- Blacks, American Indians and Alaska Natives received worse care than Whites for about 40% of core measures.
- Asians received worse care than Whites for about 20% of core measures.
- Poor people received worse care than high-income people for about 80% of core measures.
Slide 6
AHRQ Priority Populations Inclusion Policy
- Inner city and rural areas (including frontier areas).
- Low income groups.
- Racial and ethnic minority groups.
- Women and children.
- The elderly.
- Individuals with special health care needs, including individuals with disabilities and those who need chronic care or end-of-life health care.
Slide 7
Strategies for Action within Agency Programs
- Leverage Legislation.
- Budget Development & Execution.
- Grant and Contract Policies.
- Clear Articulation of Disparities Research, Dissemination & Implementation Priorities.
- Tracking and Evaluation.
Slide 8
Articulating Priority & Innovation
- Address disparities reduction in conceptual, intervention and analytic models.
- Balanced projects within an initiative with a require focus on improving outcomes for specific populations:
- Research Centers of Excellence in Clinical Preventive Services (RFA-HS-11-005).
- Innovations in peer review:
- Require disparities focus (where appropriate).
- Selection of reviewers & specific guidance.
- Extra points for addressing disparities or outcomes for priority populations.
Slide 9
Patient Protection and Affordable Care Act (ACA)
- Includes a significant focus on reducing health disparities and improving the health of diverse populations.
- Requires data collection and reporting by race, ethnicity, primary language & disability status.
- Will provide an evidence base for action by identifying gaps and trends.
- Requires development of a National Quality Strategy:
- Reducing health disparities across populations is a criterion for priority setting
Slide 10
ACA and Disparities Research
- New Office of Minority Health at AHRQ.
- Patient-centered Outcomes Research Institute:
- Comparative effectiveness research.
- Research funding (peer review & public comment required).
- Requires a focus on racial and ethnic minorities, gender, age, and health disparities.
- AHRQ funding: $8M in FY11, $24M in FY12.
Slide 11
ACA Provisions and AHRQ
- New Office of Minority Health at AHRQ:
- AHRQ Action Plan linked to HHS Action Plan to Reduce Disparities.
- Sets specific objectives and expectations and requires accountability.
- Specific Research Priorities:
- Research Centers for Excellence in Clinical Preventive Services (RFA-HS-11-005) — Health Equity Research Center of Excellence.
- Research on Health Issues for Minority Women (NOT-HS-11-013).
Slide 12
Thank You
AHRQ Mission
To improve the quality, safety, efficiency, and effectiveness of health care for all Americans.
AHRQ Vision
As a result of AHRQ's efforts, American health care will provide services of the highest quality, with the best possible outcomes, at the lowest cost.