Roadmap
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
„ Finding
Answers
„ Key Questions
AcademyHealth June 26, 2006
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.
Grants
„ Cardiovascular
disease, diabetes,
depression
„ 3 Call for Proposals over 4 years
„ 2020-25 grants
„ $5 million - $50K$50K-$300K
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.
Eligible Interventions
„ Patient
– e.g. disease management
– e.g. cultural competency
„ Organization – e.g. QI
„ Community linkage – e.g. CHW
„ Policy – e.g. P4P
„ Provider
1
Systematic Reviews:
3 Products
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
„ Supplement
to Med Care Research Review
„ Searchable database on website – CVD,
DM, Depression
„ Policy briefs
– Launch end of 2006
„ Call
for Proposals Cycle 3 – late 2007
„ www.solvingdisparities.org
Med Care Research Review
„ Intro
„ Lots
of general QI interventions
few studying minority
populations
„ Vanishingly few on disparity reduction
„ Holes
„ CVD
„ Relatively
„ DM
„ Depression
„ Breast
cancer
„ CultureCulture-specific
„ P4P
Observations
and public reporting
„ Policy
Key Questions: Targeting
„ Mix
of general QI vs. cultureculture-specific
– Raise the tide of all vs. target
– All providers vs. predominant providers of
minority patients
– General QI techniques vs. cultureculture-specific
„ Operationalizing
cultureculture-specific
– PatientPatient-centered and cultural competency
– Physical and mental – e.g. stigma
Key Questions: Implementation
„ Inside
black box of implementation
- $, effort, practical tools
„ Sustainable
„ Multicomponent – prioritization and
resource allocation
„ Unintended consequences
„ Replicable
– Positive
– Negative
2
Key Questions:
Community and Policy
Key Questions: Cost
„ Cost
issues – business and societal
– Aligning the incentives
„ Resource
capacity, esp. for predominant
providers of minority patients
„ Leverage
full strengths of both community
and health care system
– Public health and medical care
– CommunityCommunity-based participatory research
„ P4P,
public reporting, financial incentives
3