In order to compare HEDIS-mandated services with the preventive needs of low income populations in our community, we undertook three surveys-one on the in-patient internal medicine service of a Veterans Administration Hospital, one in federal housing projects (largely African American), and one among Latino residents of multi-family dwellings. In each survey, participants were asked about preventive services as per recommendations of the U.S. Preventive Services Task Force. Results from all three surveys were comparable regarding HEDIS. In all, 829 people participated (290 in a one year survey of all elligible patients at the VA, 196 from a 4% random sample of housing project households, and 343 from a convenience sample of the multi-family dwellings), and 7,673 unmet preventive needs were found(9.1 per person). Five needs (dental screening, PPD testing, dietary counseling, regular exercise and smoking cessation) accounted for 2,369 (31% of the total).Five additional needs(hepatitis B immunization, Td immunization, counseling for STD, blood pressure screening and screening with a structured interview for alcohol consumption) accounted for another 21%. For all three populations, these data show that it would have been possible to receive a perfect score from HEDIS, even though 95% of preventive needs went unmet. As such, the HEDIS criteria did not reflect actual preventive needs of many people served by organizations receiving HEDIS ratings within our community. Since the prevalence of preventable risk factors is higher among economically vulnerable populations, prioritization/rating schemes such as HEDIS may have the effect perpetuating health inequalities.
Learning Objectives: At the end of this session, participants will be able to discuss the possible negative effects of priority-based prevention evaluation methods on the health of low income populations.
Keywords: HEDIS, Low-Income
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Meharry Medical College and its affiliate clinics.
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Presenter is a resident and thus an employee of Meharry Medical College, and this work was done at a Meharry affiliate clinic.