Lisa A. Cooper|Martha N. Hill|Neil R. Powe
Designing and evaluating interventions to eliminate racial and ethnic disparities in health care
Welch Foundation|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Welch Foundation|Johns Hopkins University
large number factors contribute racial ethnic dispartities health status health care professionals researchers policymakers believed time access care centerpiece elimination health disparities institute medicines iom model access health services includes personal financial structural barriers health service utilization mediators care model used describe interactions among factors impact health outcomes equity services among racial ethnic groups present modified version iom model incorporates features access models highlights barriers mediators relevant interventions designed eliminate disparities us health care also suggest interventions eliminate disparities achieve equity health care services considered within broader context improving quality care health service intervention studies shown improvements health disadvantaged groups properly designed implemented interventions could used reduce health disparities successful features interventions include use multifaceted intense approaches culturally linguistically appropriate methods improved access care tailoring establishment partnerships stakeholders community involvement however order effective reducing disparities health care health status important limitations previous studies need addressed including lack control groups nonrandom assignment subjects experimental interventions use health outcome measures validated interventions might improved targeting highrisk populations focusing important contributing factors including measures appropriateness quality care health outcomes prioritizing dissemination efforts