Document Detail

Reducing health disparities: strategy planning and implementation in Israel's largest health care organization.
MedLine Citation:
PMID:  21352224     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe an organization-wide disparity reduction strategy and to assess its success in quality improvement and reduction of gaps in health and health care.
STUDY SETTING: Clalit Health Services, Israel's largest non-for-profit insurer and provider serving 3.8 million persons.
STUDY DESIGN: Before and after design: quality assessment before and 12-month postinitiation of the strategic plan. A composite weighted score of seven quality indicators, measuring attainment of diabetes, blood pressure, and lipid control, lack of anemia in infants, and performance of mammography, occult blood tests, and influenza vaccinations.
DATA EXTRACTION METHODS: Quality indicator scores, derived from Clalit's central data warehouse, based on data from electronic medical records.
PRINCIPAL FINDINGS: Low-performing clinics, of low-socioeconomic and minority populations, were targeted for intervention. Twelve months after the initiation of the project continuous improvement was observed coupled with a reduction of 40 percent of the gap between disadvantaged clinics, serving ~10 percent of enrollees, and all other medium-large clinics.
CONCLUSION: The comprehensive strategy, following a quality improvement framework, with a top-down top-management incentives and monitoring, and a bottom-up locally tailored interventions, approach, is showing promising results of overall quality improvement coupled with disparity reduction in key health and health care indicators.
Ran D Balicer; Efrat Shadmi; Nicky Lieberman; Sari Greenberg-Dotan; Margalit Goldfracht; Liora Jana; Arnon D Cohen; Sigal Regev-Rosenberg; Orit Jacobson
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Publication Detail:
Type:  Journal Article     Date:  2011-02-25
Journal Detail:
Title:  Health services research     Volume:  46     ISSN:  1475-6773     ISO Abbreviation:  Health Serv Res     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-06     Completed Date:  2011-09-07     Revised Date:  2013-08-20    
Medline Journal Info:
Nlm Unique ID:  0053006     Medline TA:  Health Serv Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1281-99     Citation Subset:  IM    
Copyright Information:
© Health Research and Educational Trust.
Faculty of Social Welfare and Health Sciences, Haifa University, Mount Carmel, Israel.
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MeSH Terms
Ambulatory Care Facilities / organization & administration
Health Services Administration / statistics & numerical data*
Health Services Research / statistics & numerical data
Health Status Disparities*
Healthcare Disparities / statistics & numerical data*
Minority Groups / statistics & numerical data
Primary Health Care / organization & administration
Program Evaluation
Quality Improvement / organization & administration*
Quality Indicators, Health Care / organization & administration*
Socioeconomic Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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