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Disparities in Ambulatory Care for Cardiovascular Disease

Baltimore, MD, USA

The challenge

Disparities in health care quality are a widely recognized challenge facing the U.S. One contributing factor is that quality of care for underinsured and minority patients receive can vary among health care providers. However, evidence suggests that different patients may experience variations in quality from the same provider. Such a possibility demands a closer look, especially when providers are delivering ambulatory care or managing chronic conditions, such as cardiovascular disease (CVD).

The vision

Johns Hopkins University is one of the country’s pre-eminent research institutions, annually performing billions of dollars of medical, science and engineering research. Johns Hopkins’ Bloomberg School of Public Health focuses on advancing research, education and practice to create solutions to public health problems around the world. Part of this work is to research potential approaches to reducing health disparities.

The approach

With funding from Aetna Foundation, researchers from the Bloomberg School of Public Health are studying national trends in ambulatory care quality for the treatment of CVD, hypertension and diabetes. They are reviewing recent medical literature to see whether disparities have narrowed or widened over the past decade and why. Researchers will catalog quality outcome measures, such as care coordination, disease monitoring and control, diagnostic testing and use of surgery and medications. They hope to reveal the extent to which quality disparities are due to differences in how individual providers care for different groups of patients. They then will look for correlations between quality disparities and various provider characteristics, such as physician race, credentials, use of electronic medical records and practice ownership and size.

The results

The group will share findings with other researchers, policymakers and health insurers through peer-reviewed journals and conference presentations. This work may help to identify ways to improve quality monitoring, suggest reforms to redress inequities, and create stronger incentives for care coordination. The research may also help to shape policies that can improve how physicians serve minority and low-income patients and how we recruit highly qualified physicians in minority and low-income communities.

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