Measuring equity: an index of health care disparities.
OBJECTIVE
To create an index that would serve as a simple tool to measure the quality of hospital care by race and ethnicity.


METHODS
Following extensive review of existing disparities indices, we created a disparities quality index (DQI) designed to easily measure differences in the quality of care hospitals deliver to different populations. The DQI uses performance data already collected by virtually all hospitals. It highlights areas where there are large numbers of patients in a specific population receiving potentially lower-quality care.


METHODS
Data were collected from 2 acute care hospitals that participated in a multihospital collaborative.


METHODS
We applied the DQI to 2 hospitals' quality data, specifically to their performance on the Hospital Quality Alliance measure for patients with heart failure who were receiving angiotensin-converting enzyme inhibitor or angiotensin receptor blocker.


RESULTS
The DQI was simple to apply and was able to measure differences in the care of different ethnic groups. It also detected changes in disparities over time.


CONCLUSIONS
The DQI can help hospitals and other providers focus on the domain of equity in their quality-improvement efforts. Further testing is required to determine its applicability for community-wide equity projects.
Department of Health Policy, School of Public Health and Health Services, The George Washington University, Washington, DC, USA. Siegel@gwumc.edu
Bruce
B
Siegel
Deborah
D
Bear
Ellie
E
Andres
Holly
H
Mead
D000043:Abstracting and Indexing; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D005006:Ethnicity; D054625:Healthcare Disparities; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D008913:Minority Groups; D011787:Quality of Health Care / Q000592:standards*; D011945:Receptors, Angiotensin / Q000627:therapeutic use; D013223:Statistics as Topic; D014481:United States; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D011945:Receptors, Angiotensin