191.0 Medical Care: Methodological Issues in Measuring and Reporting Disparities - 1

Sunday, October 30, 2011: 2:00 PM
Business Meeting
Introduction Disparities exist across all aspects of health and healthcare including specific conditions such as cancer and diabetes; types of care, and care settings. There is increasing clinical and policy focus on eliminating disparities in health care (the Affordable care Act) and health (Healthy People 2020 goals). Performance measurement, reporting, and monitoring play an important role in both assessing disparities and measuring progress in addressing them. However, there are many methodological issues and controversies related to measuring and reporting disparities and tracking change over time. Recently, the IOM released a report providing recommendations for standardizing data collection of race, ethnicity, and language, and both the National Committee for Quality Assurance (NCQA) and the Joint Commission published standards for improving quality among disparities populations. Given increased focus on measuring and reporting disparities through provisions in the Accountable Care Act and on implementing interventions aimed at eliminating disparities, solutions to these measurement issues are critical. Different approaches to measurement may result in different results. This year's access study session will present new and innovative work that addresses these challenges including: absolute versus relative disparities and implications for static versus time trends; paired measures (e.g., white compared with black, white compared with Latino) versus summary indexes (disparities among all groups considered simultaneously); consideration of "directionality" (i.e., if vulnerable populations have higher quality of care than the majority population, is this considered a disparity and should action be taken?); comparisons across geographic areas or across indicators; sample size considerations; single vs. composite measures, risk adjustment and stratification; and consideration and measurement of disparities between and within providers (geographic variation). These measurement approaches have direct applicability to performance measurement and reporting, evaluation of promising interventions, and in monitoring progress. Strengths and limitations of different approaches will be discussed. A round table discussion with members of the session will follow presentations. The session is designed to be informal and highly interactive.
Session Objectives: 1. To understand methodologic issues related to measuring and reporting health disparities and implications for practice, policy, and research. 2. To understand new approaches and methods for measuring and monitoring health disparities and their applications. 3. To gain insight into how these approaches can be applied to the work of session participants.

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