185426 Access to quality healthcare resources for chronic disease patients in South Los Angeles: A stakeholder collaborative assessment

Sunday, October 26, 2008

Disparities in Healthcare Advisory Committee , Community Health Councils, Los Angeles, CA
The South LA Healthcare Resources Assessment was conducted by the Disparities in Healthcare Advisory Committee convened by Community Health Councils, assessed quality healthcare access among South LA patients with CVD and diabetes by examining the disparities in the area. The target area was South Los Angeles (30% AA; 2% Caucasian). The contrast area was West LA, which was nearly half Caucasian and only 7.5% AA. The committee sought to identify differences between the two areas for 1) the number of healthcare resources available, 2) CVD/diabetic surgery procedures and 3) the number and type of CVD and diabetes management programs. Secondary data sources including county and state healthcare services databases were examined. A survey instrument was developed and administered to clinics and hospitals to gather chronic disease management program data.

Several disparities were identified. Fewer doctors, pharmacies and hospitals with emergency departments were found in the target area. For-profit dialysis centers more than doubled the number in the contrast area. The majority target area patient discharges were from 21 hospitals and contrast area patients from only 8 hospitals, which suggests that some South LA patients must travel longer distances to obtain certain hospital care services. More community clinics existed in the target area, though largely serving the uninsured.

The study's community-based approach combined practical data collection useful to service providers while demonstrating to community stakeholders and policymakers that racial/ethnic disparities still exist in quality and availability and must be challenged. The information proved beneficial to the committee in understanding what types of resources are necessary to improve patient outcomes in South Los Angeles. It is also anticipated that it will provide a powerful tool to advocate for more effective health policies and increased funding for providers in one of the most underserved areas of Los Angeles.

While the research process went relatively smoothly it took more than one year to complete. The academic partner played a lesser role than anticipated in data collection so CHC staff took the lead. The CBPR process and the complexity and breadth of the study design and data collection took more time as well. Finally, the research may have also taken focus away from other activities such as advocacy or joint program planning and implementation. Communities should weigh the benefits of such a project against other needs in the planning stage. Limiting research areas, training community-based researchers and clear MOUs with research partners are also recommended.

Learning Objectives:
1. Construct a framework to assess utilization of healthcare resources in a defined geographic area. 2. Apply community based participatory research to policy development and advocacy efforts. 3. Discuss the effectiveness of the CBPR model in strengthening and buidling coalitions around specific health issues.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Members of the committee represent UC system public health research departments, professional healthcare provider organizations, and are individual providers, and have authored numerous peer reviewed journal articles and books on the subject of racial and ethnic disparities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.