Health Equity and Quality of Care Assessment: A Continuing Challenge.

Abstract

Reducing racial and/or ethnic disparities in a variety of health outcomes from neonatal, infant, and adult mortality to premature birth rates has been a hospital, state, and national goal. One area of focus has been differences in the types of care (or quality of care) that patients from minority racial/ethnic groups receive compared with non-Hispanic white patients. Profit et al1 provide new evidence of this potential issue as applied to perinatal medicine. By using data from >100 perinatal hospitals in California, the authors document substantial differences in the care quality received by non-Hispanic African American and Hispanic patients compared with non-Hispanic white patients. The magnitude of these differences as assessed by the Baby-MONITOR care tool varied between hospitals, with some hospitals showing higher quality of care in minority racial and/or ethnic patients and other hospitals showing much lower quality. Beyond these important findings, though, this research also highlights the substantial challenge when combining health equity goals with the measurement of health care quality. Researchers and policy makers can take 1 of 3 approaches to assess the care quality differences that may underlie health disparities. Profit et al1 use the most common mechanism: apply a set of previously validated quality measures … Address correspondence to Scott A. Lorch, MD, MSCE, Department of Pediatrics, Roberts Center for Pediatric Research, 2716 South St, Floor 10, Room 10215, Philadelphia, PA 19146. E-mail: lorch{at}email.chop.edu