Sustained Reduction in Health Disparities Achieved through Targeted Quality Improvement: One‐Year Follow‐up on a Three‐Year Intervention

Objective

To assess a quality improvement disparity reduction intervention and its sustainability.

Data Sources/Study Setting

Electronic health records and Quality Index database of Clalit Health Services in Israel (2008–2012).

Study Design

Interrupted time‐series with pre‐, during, and postintervention disparities measurement between 55 target clinics (serving approximately 400,000 mostly low socioeconomic, minority populations) and all other (126) clinics.

Data Collection/Extraction Methods

Data on a Quality Indicator Disparity Scale (‐7) of 7 indicators, and on a 61‐indicator scale (‐61).

Principal Findings

The gap between intervention and nonintervention clinics for ‐7 decreased by 66.7 percent and by 70.4 percent for ‐61. Disparity reduction continued (18.2 percent) during the follow‐up period.

Conclusions

Quality improvement can achieve significant reduction in disparities in a wide range of clinical domains, which can be sustained over time.