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Key Disparities Research Questions

Key Disparities Research Questions. Marshall H. Chin, MD, MPH Associate Professor of Medicine University of Chicago Director, RWJF Finding Answers: Disparities Research for Change NPO AcademyHealth June 26, 2006. Roadmap. Finding Answers Key Questions. Finding Answers.

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Key Disparities Research Questions

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  1. Key Disparities Research Questions Marshall H. Chin, MD, MPH Associate Professor of Medicine University of Chicago Director, RWJF Finding Answers: Disparities Research for Change NPO AcademyHealth June 26, 2006

  2. Roadmap • Finding Answers • Key Questions

  3. Finding Answers • Finding Answers: Disparities Research for Change seeks to improve the quality of health care provided to patients from racial and ethnic backgrounds likely to experience disparities.

  4. Goals • Finding Answers will: • Grant funds to discover and evaluate practical and replicable solutions designed to reduce and eliminate racial and ethnic health care disparities. • Conduct systematic reviews regarding racial and ethnic health care disparities interventions. • Disseminate results.

  5. Grants • Cardiovascular disease, diabetes, depression • 3 Call for Proposals over 4 years • 20-25 grants • $5 million - $50K-$300K

  6. Eligible Interventions • Patient – e.g. disease management • Provider – e.g. cultural competency • Organization – e.g. QI • Community linkage – e.g. CHW • Policy – e.g. P4P

  7. Call for Proposals Cycles • Call for Proposals Cycle 1 • 178 Brief Proposals • 36 Full Proposal Invites • Grantees chosen October 2006 • Call for Proposals Cycle 2 • Launch end of 2006 • Call for Proposals Cycle 3 – late 2007 • www.solvingdisparities.org

  8. Systematic Reviews:3 Products • Supplement to Med Care Research Review • Searchable database on website – CVD, DM, Depression • Policy briefs

  9. Med Care Research Review • Intro • CVD • DM • Depression • Breast cancer • Culture-specific • P4P and public reporting • Policy

  10. Observations • Lots of general QI interventions • Relatively few studying minority populations • Vanishingly few on disparity reduction • Holes

  11. Key Questions: Targeting • Mix of general QI vs. culture-specific • Raise the tide of all vs. target • All providers vs. predominant providers of minority patients • General QI techniques vs. culture-specific • Operationalizing culture-specific • Patient-centered and cultural competency • Physical and mental – e.g. stigma

  12. Key Questions: Implementation • Inside black box of implementation • Replicable - $, effort, practical tools • Sustainable • Multicomponent – prioritization and resource allocation • Unintended consequences • Positive • Negative

  13. Key Questions: Cost • Cost issues – business and societal • Aligning the incentives • Resource capacity, esp. for predominant providers of minority patients

  14. Key Questions: Community and Policy • Leverage full strengths of both community and health care system • Public health and medical care • Community-based participatory research • P4P, public reporting, financial incentives

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