Measuring equity: an index of health care disparities

Abstract

Objective: To create an index that would serve as a simple tool to measure the quality of hospital care by race and ethnicity.

Study design: Following extensive review of existing disparities indices, we created a disparities quality index (DQI) designed to easily measure differences in the quality of care hospitals deliver to different populations. The DQI uses performance data already collected by virtually all hospitals. It highlights areas where there are large numbers of patients in a specific population receiving potentially lower-quality care.

Setting: Data were collected from 2 acute care hospitals that participated in a multihospital collaborative.

Data collection/extraction methods: We applied the DQI to 2 hospitals' quality data, specifically to their performance on the Hospital Quality Alliance measure for patients with heart failure who were receiving angiotensin-converting enzyme inhibitor or angiotensin receptor blocker.

Results: The DQI was simple to apply and was able to measure differences in the care of different ethnic groups. It also detected changes in disparities over time.

Conclusions: The DQI can help hospitals and other providers focus on the domain of equity in their quality-improvement efforts. Further testing is required to determine its applicability for community-wide equity projects.