Impact of the HRSA Health Disparities Collaboratives

描述：此应用程序是对AHRQ(RFA HS-02-005)的一项请求的响应，该请求要求调查人员评估健康差异协作对在参与的健康中心向患者提供护理的过程和结果的影响。我们将研究参与糖尿病II和糖尿病III协作组、心血管协作组以及哮喘I和II协作组的卫生中心。我们将描述参与的卫生中心实施的干预措施；这些中心服务的患者群体；中心的结构、人员配备、组织、管理、领导和文化；以及与地方、州和国家组织建立的外部合作伙伴关系。我们将通过与卫生中心和区域联网的主要临床和行政领导人进行访谈、审查卫生中心向其联网主任提交的月度报告以及审查卫生中心和联网工作人员编写的其他材料来实现这一点。除了使用这些数据来记录医疗中心所取得的成就外，我们还将把它们与从患者病历中收集的有关护理过程和结果的信息结合起来，并解决以下具体目标：1)评估参与健康差异协作是否会改善护理过程和结果。以及2)确定与护理质量积极变化相关的健康中心、改进团队和改进方法的特点。对于每种疾病，我们将抽样15个参与协作的健康中心，并从参与前接受护理的每个中心35名患者和参与后接受护理的每个中心35名患者的医疗图表中收集护理过程和结果数据。将在每个卫生中心对相同数量的未作为干预目标的疾病之一的患者进行抽样。后一组患者将包括用于我们分析的对照样本之一。此外，从15个健康中心的匹配样本中，我们将从每个中心每种情况下70名患者的医疗记录中收集数据。这些健康中心没有参与协作，但在其他情况下有资格参与。这些患者中的一半将在协作性活动之前的时间段进行抽样，另一半将在协作性活动之后的时期进行抽样。这些患者是我们分析的第二个对照样本。总体而言，我们将研究总共60个健康中心和9450名患者(每种情况3150人)。这项研究的结果将表明，健康差异协作是否更接近其提供100%机会和消除差异的目标。

DESCRIPTION: This application is in response to a request by AHRQ (RFA HS-02-005) for investigators to assess the impact of the Health Disparities Collaboratives on the processes and outcomes of care provided to patients cared for at participating health centers. We will study health centers that participated in the Diabetes II and Diabetes III Collaboratives, the Cardiovascular Collaborative, and the Asthma I and II Collaboratives. We will describe the interventions implemented by participating health centers; the patient populations served by the centers; the structure, staffing, organization, management, leadership, and culture of the centers; and the external partnerships formed with local, state, and national organizations. We will achieve this by conducting interviews with key clinical and administrative leaders at the health centers and the regional clusters; by reviewing monthly reports submitted by health centers to their Cluster Directors; and by reviewing other materials generated by staff from health centers and clusters. In addition to using these data to document what the health centers have accomplished, we will combine them with information on the processes and outcomes of care collected from patients' medical records and address the following specific aims: 1)evaluate whether participation in a Health Disparities Collaborative leads to improved processes and outcomes of care. and 2)identify the characteristics of the health centers, improvement teams, and improvement methods associated with positive change in quality of care. For each disease, we will sample 15 health centers that participated in a Collaborative and collect processes of care and outcomes data from the medical charts of 35 patients per center who received care prior to participation and 35 patients per center who received care following participation. The same number of patients with one of the conditions not targeted for intervention will be sampled at each of these health centers. The latter patients will comprise one of the control samples for our analyses. In addition, from a matched sample of 15 health centers that did not participate in a Collaborative, but that are otherwise eligible to do so, we will collect data from medical records of 70 patients per center per condition. Half of these patients will be sampled to coincide with a time period prior to the Collaboratives and half will be sampled to coincide with a period following the Collaboratives. These patients represent a second control sample for our analyses. Overall, we will study a total of 60 health centers and 9,450 patients (3,150 per condition). The results of this study will indicate whether the Health Disparities Collaboratives are nearer their goal of providing 100 percent access and eliminating disparities.