TBD

待定

• 批准号: 8896337
• 负责人: DAVID SATCHER
• 金额: $ 21.16万
• 依托单位: MOREHOUSE SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8896337
• 关键词: Address; Adoption; Affect; Caring; Chronic Disease; Clinical Trials; Collection; Communities; Complex; Country; Data; Data Collection; Data Reporting; Electronics; Ethnic Origin; Gender; Gender Identity; Goals; Group Practice; Health; Health Care Costs; Health Insurance; Health Policy; Health Professional; Health Promotion; Health Services; Health Services Accessibility; Health Status; Healthcare; Home environment; Incentives; Insurance; Insurance Coverage; Intervention; Investments; Language; Language Disorders; Laws; Lead; Learning; Life; Low income; Medicaid; Medical center; Medicare; Minority Groups; Modeling; Patients; Policies; Policy Research; Prevention; Primary Care Physician; Primary Health Care; Provider; Public Health; Public Policy; Publishing; Quality of Care; Race; Records; Relative (related person); Reporting; Research; Risk Adjustment; Rural Population; Sex Orientation; Solutions; System; Training; Underserved Population; Unemployment; Uninsured; United States; United States Centers for Medicare and Medicaid Services; Vulnerable Populations; Work; base; beneficiary; comparative effectiveness; cost; court; cultural competence; disorder prevention; dual eligible; effectiveness research; experience; health care quality; health disparity; health equity; health information technology; health practice; high risk; improved; innovation; men who have sex with men; payment; programs; racial and ethnic; sex; social health determinants

Disparities Report, which tracks the inequities in health services in the United States. Since the report was first published in 2003, the findings have consistently shown that while we have made improvements in quality, we have not been as successful in reducing disparities in healthcare. This dichotomy has resulted despite the fact that we continue to spend more on healthcare. Healthcare costs have been escalating an unsustainable rate, reaching an estimated 17.3 percent of our gross domestic product in 2009 according to the Centers for Medicare and Medicaid Services (CMS). Despite these high costs for the provision of health services in the United States, we continue to observe delivery system fragmentation and inequities in the quality of healthcare delivered. Likewise, when we look at the disparities in health status and access to care for racial and ethnic minorifies, the numbers are quite alarming! Each year approximately 83,000 racial and ethnic minorities die as a result of health disparities and as a nation we are spending an estimated $300 billion as a result of these disparifies. When we add in the social determinants of health - realizing that healthcare alone cannot adequately improve health overall or reduce health disparities without addressing where and how people live - you can see how complex this issue is. Despite the fact that health equity is a key component of the transforming journey of healthcare that we are all embarking on, little has been done to comprehensively and trans-disciplinarily coordinate health policy research, analysis, and collaboratively address this serious problem at the local, state, regional, and national level. With the passage of several health-related policies in recent years, the focus has been on bending the cost curve and becoming more efficient with less moving fon/vard. While it may be difficult to predict the unintended consequences of many of these policies, by leveraging the collective strengths and expertise of our partners we can tackle the grave health disparities confronting racial and ethnic minorities. One significant health policy being advanced is the ACA, which includes provisions addressing health equity and the elimination of disparifies in health status and healthcare among vulnerable populations. The ACA includes health equity-related provisions, which provide a bridge to health equity that affords marginalized groups - particularly racial and ethnic minorities - increased access to culturally appropriate care, quality healthcare, preventative care, and comparative effectiveness research. For racial and ethnic minorities who are the most likely to be uninsured, experience higher unemployment rates, and have a lower income - which makes it harder to obtain employer-sponsored health insurance coverage - Medicaid expansion and the creation of health insurance exchanges would provide these communities access to vital health services. In addition, the ACA provides a unique opportunity to expand the scope of research related to health disparities, increase diversity in clinical trials, and identify, develop and distribute appropriate interventions and solutions to address these disparities. The law also provides new investments to increase the number of culturally competent primary care physicians and other health professionals. For these reasons, the implementation of the ACA offers a critical opportunity to realize the goal of achieving health equity throughout our country. The recent Supreme Court ruling on the ACA, while essentially weakening a key aspect of the ACA's efforts to expand health insurance coverage to the working poor - Medicaid Expansion - by making the expansion of this program optional for states, nevertheless upheld the ACA and the provisions aimed at addressing health disparities. As a result, MSM will help states within Region IV strengthen their health equity and health reform agendas, and inform other states of lessons learned.

该报告跟踪了美国医疗服务中的不平等现象。因为这份报告是第一个 2003年发表的调查结果一直表明，虽然我们在质量上有所改进，但我们 在减少医疗保健方面的差距方面并不是很成功。尽管有这样一个事实，这种二分法还是导致了 我们继续在医疗保健方面投入更多资金。医疗成本一直在以不可持续的速度上升， 根据经济合作与发展中心的数据，2009年我国国内生产总值估计将达到17.3% 医疗保险和医疗补助服务(CMS)。尽管在美国提供保健服务的成本很高， 在美国，我们继续观察到医疗保健质量方面的提供系统支离破碎和不平等 送来了。 同样，当我们看到健康状况和获得护理的机会方面的差异时，种族和族裔被边缘化， 这些数字相当令人震惊！每年约有83,000名少数族裔和少数民族死于 健康差距，作为一个国家，由于这些不同，我们估计花费了3000亿美元。 当我们加入健康的社会决定因素时-意识到仅靠医疗保健不能充分改善 整体健康或减少健康差距，而不解决人们生活在哪里和如何生活-您可以看到 这个问题很复杂。 尽管健康公平是医疗保健转型之旅的一个关键组成部分，但我们都是 开始，在全面和跨学科协调卫生政策方面做得很少 研究、分析和协作解决地方、州、地区和国家的这一严重问题 水平。 随着近年来几项与健康相关的政策的通过，人们的焦点一直放在压低成本上 曲线，并变得更有效率，更少的移动的前锋/前锋。虽然可能很难预测意外的 通过利用我们合作伙伴的集体优势和专业知识，实现上述许多政策的后果 我们能够解决种族和少数民族面临的严重健康差距。 正在推进的一项重要的卫生政策是ACA，其中包括涉及卫生公平的条款 以及消除弱势群体在健康状况和医疗保健方面的差异。ACA 包括与健康公平有关的条款，这些条款提供了通向健康公平的桥梁，使边缘化的人能够 群体--特别是种族和族裔少数群体--更多地获得文化上适当的护理、质量 医疗保健、预防性护理和比较有效性研究。针对种族和少数民族，他们 最有可能没有保险，失业率更高，收入更低--这些 使获得雇主赞助的医疗保险范围变得更加困难-医疗补助扩大和 创建医疗保险交易所将为这些社区提供重要的医疗服务。在……里面 此外，ACA提供了一个独特的机会来扩大与健康差距有关的研究范围， 增加临床试验的多样性，并确定、开发和分发适当的干预措施和解决方案 解决这些差距。该法律还提供了新的投资，以增加文化上的 有能力的初级保健医生和其他卫生专业人员。 出于这些原因，《行动纲领》的实施为实现以下目标提供了一个重要机会： 在我们国家实现卫生公平。最高法院最近对ACA的裁决，虽然基本上 削弱了ACA将医疗保险覆盖范围扩大到贫困工人的努力的一个关键方面- 医疗补助计划的扩大-通过使该计划的扩大对各州来说是可选的，尽管如此，仍支持 ACA和旨在解决健康差距的规定。因此，MSM将帮助区域内的各州 加强其卫生公平和卫生改革议程，并向其他国家通报所吸取的经验教训。