Addressing Health Disparities

07 Aug 2013
Memphis, TN, is a city of diversity. According to the latest census data, 63 percent of the population is African American. Common Table Health Alliance (CTHA), leader of the Aligning Forces for Quality (AF4Q) initiative in Memphis, is leading hospitals toward gathering information on patient race, ethnicity, and language preference (R/E/L) to identify any gaps in health care among different populations. 
The Institute of Medicine’s 2002 report “Unequal Treatment” catalogued consistent evidence of disparities of care provided in the United States. By collecting patient R/E/L data, hospitals can pinpoint possible differences in care and areas for improvement. In this way, CTHA is helping care become more equitable. The goal is for Memphis to stratify both ambulatory and hospital care performance measures. If outcomes are different, then hospitals and providers will be able to address problems to provide the best possible care. 
One of the major Memphis hospitals, Methodist North hospital, participated in the Aligning Forces Equity Improvement Collaborative. As of 2012, both Methodist North and Methodist South hospitals participated in the Hospital Quality Network Reducing Readmissions project, adopting standardized collection of R/E/L. Baptist Health Services group, another large health system, also has begun collecting R/E/L data. Both networks plan to spread R/E/L data collection. 
CTHA's findings in its Health Equity report show disparities in care between African Americans and other racial groups in Memphis. The African American Medicare population is much less likely to visit their primary care clinician than their counterparts of other races. In Memphis, barriers such as cost, proximity of primary care clinicians, and availability of transportation services all contribute to disparities in care. African Americans are three times more likely to have a lower extremity amputated due to complications from diabetes than other racial groups. Mammograms are also a problem area for equity; African American women in Memphis are much less likely to use this preventive tool. This may put African American women at a higher risk of death from breast cancer. This results in a disproportionate number of deaths from breast cancer among African American women. 
To address these disparities, the Hospital Quality Network is collecting and analyzing length of hospital stay data stratified by race and ethnicity for a community-wide measure. CTHA continues to gather data so opportunities for improvement can be identified, and ultimately equity can be achieved.