TY - JOUR
KW - Adult
KW - Asthma -- ethnology
KW - Child
KW - Cooperative Behavior
KW - Delivery of Health Care -- organization & administration
KW - Emigrants and Immigrants
KW - Ethnic Groups
KW - Health Plan Implementation
KW - Health Services Research -- organization & administration
KW - Healthcare Disparities
KW - Humans
KW - Immunization Programs -- organization & administration
KW - Interdisciplinary Communication
KW - Patient Care Team
KW - Preventive Health Services -- organization & administration
KW - Quality Assurance, Health Care -- organization & administration
KW - United States
AU - M. H. Chin
AU - M. Alexander-Young
AU - D. L. Burnet
A1 - 
AB - Relatively few quality-improvement efforts have been aimed at reducing differences in children's care and outcomes across race and ethnicity, socioeconomic status, and insurance status. To inform quality-improvement efforts to reduce child health disparities, we summarize lessons learned from the adult disparities-intervention literature, identify interventions that have reduced disparities in pediatric asthma outcomes and immunization rates, and outline special considerations for child disparity interventions. Key recommendations for providers, health care organizations, and researchers include: (1) examine your performance data stratified according to insurance status, race/ethnicity, language, and socioeconomic status; (2) measure and improve childhood health-related quality of life, development, and condition-specific targets (such as asthma and immunizations); (3) measure and improve anticipatory guidance for early prevention of conditions (such as injuries, violence, substance abuse, and sexually transmitted diseases) and efforts to promote positive growth (such as readership programs to improve low literacy); (4) measure and improve structural aspects of care that affect child health outcomes and can reduce disparities, such as patient-centered medical-home elements; (5) incorporate families into interventions; (6) use multidisciplinary teams with close tracking and follow-up of patients; (7) integrate non-health care partners into quality-improvement interventions; and (8) culturally tailor quality improvement. A key recommendation for payers is to align financial incentives to reduce disparities. The National Institutes of Health and other funders should support (1) disparity-intervention studies on these recommendations that analyze clinical outcomes, intervention-implementation processes, and costs, and (2) creation of new child health services researchers who can find effective quality-improvement approaches for reducing disparities.
BT - Pediatrics
C5 - Medical Home; Healthcare Policy
CY - United States
JF - Pediatrics
N2 - Relatively few quality-improvement efforts have been aimed at reducing differences in children's care and outcomes across race and ethnicity, socioeconomic status, and insurance status. To inform quality-improvement efforts to reduce child health disparities, we summarize lessons learned from the adult disparities-intervention literature, identify interventions that have reduced disparities in pediatric asthma outcomes and immunization rates, and outline special considerations for child disparity interventions. Key recommendations for providers, health care organizations, and researchers include: (1) examine your performance data stratified according to insurance status, race/ethnicity, language, and socioeconomic status; (2) measure and improve childhood health-related quality of life, development, and condition-specific targets (such as asthma and immunizations); (3) measure and improve anticipatory guidance for early prevention of conditions (such as injuries, violence, substance abuse, and sexually transmitted diseases) and efforts to promote positive growth (such as readership programs to improve low literacy); (4) measure and improve structural aspects of care that affect child health outcomes and can reduce disparities, such as patient-centered medical-home elements; (5) incorporate families into interventions; (6) use multidisciplinary teams with close tracking and follow-up of patients; (7) integrate non-health care partners into quality-improvement interventions; and (8) culturally tailor quality improvement. A key recommendation for payers is to align financial incentives to reduce disparities. The National Institutes of Health and other funders should support (1) disparity-intervention studies on these recommendations that analyze clinical outcomes, intervention-implementation processes, and costs, and (2) creation of new child health services researchers who can find effective quality-improvement approaches for reducing disparities.
PP - United States
PY - 2009
SN - 0031-4005 (Print); 1098-4275 (Electronic)
EP - 36
EP - S224+
T1 - Health care quality-improvement approaches to reducing child health disparities
T2 - Pediatrics
TI - Health care quality-improvement approaches to reducing child health disparities
U1 - Medical Home; Healthcare Policy
U2 - 19861474
VL - 124 Suppl 3
VO - 0031-4005 (Print); 1098-4275 (Electronic)
Y1 - 2009
ER -