Sustained Reduction in Health Disparities Achieved through Targeted Quality Improvement: One-Year Follow-up on a Three-Year Intervention

Health Serv Res. 2015 Dec;50(6):1891-909. doi: 10.1111/1475-6773.12300. Epub 2015 Mar 19.


Objective: To assess a quality improvement disparity reduction intervention and its sustainability.

Data sources/study setting: Electronic health records and Quality Index database of Clalit Health Services in Israel (2008-2012).

Study design: Interrupted time-series with pre-, during, and postintervention disparities measurement between 55 target clinics (serving approximately 400,000 mostly low socioeconomic, minority populations) and all other (126) clinics.

Data collection/extraction methods: Data on a Quality Indicator Disparity Scale (QUIDS-7) of 7 indicators, and on a 61-indicator scale (QUIDS-61).

Principal findings: The gap between intervention and nonintervention clinics for QUIDS-7 decreased by 66.7 percent and by 70.4 percent for QUIDS-61. Disparity reduction continued (18.2 percent) during the follow-up period.

Conclusions: Quality improvement can achieve significant reduction in disparities in a wide range of clinical domains, which can be sustained over time.

Keywords: Health disparities; intervention; quality improvement.

MeSH terms

  • Health Services Research
  • Health Status Disparities*
  • Healthcare Disparities*
  • Humans
  • Interrupted Time Series Analysis
  • Israel
  • Minority Groups*
  • Patient Care Team
  • Poverty*
  • Quality Improvement / organization & administration*
  • Quality Indicators, Health Care
  • Socioeconomic Factors