Inequality in quality: Addressing socioeconomic, racial and ethnic disparities in health care

Kevin Fiscella, Peter Franks, Marthe R. Gold, Carolyn M. Clancy

Research output: Contribution to journalArticlepeer-review

797 Scopus citations

Abstract

Socioeconomic and racial/ethnic disparities in health care quality have been extensively documented. Recently, the elimination of disparities in health care has become the focus of a national initiative. Yet, there is little effort to monitor and address disparities in health care through organizational quality improvement. After reviewing literature on disparities in health care, we discuss the limitations in existing quality assessment for identifying and addressing these disparities. We propose 5 principles to address these disparities through modifications in quality performance measures: disparities represent a significant quality problem; current data collection efforts are inadequate to identify and address disparities; clinical performance measures should be stratified by race/ethnicity and socioeconomic position for public reporting; population-wide monitoring should incorporate adjustment for race/ethnicity and socioeconomic position; and strategies to adjust payment for race/ethnicity and socioeconomic position should be considered to reflect the known effects of both on morbidity.

Original languageEnglish (US)
Pages (from-to)2579-2584
Number of pages6
JournalJournal of the American Medical Association
Volume283
Issue number19
StatePublished - May 17 2000
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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