title: Sustained Reduction in Health Disparities Achieved through Targeted Quality Improvement: One-Year Follow-up on a Three-Year Intervention.
abstract: OBJECTIVE
  To assess a quality improvement disparity reduction intervention and its sustainability.
  
  
  METHODS
  Electronic health records and Quality Index database of Clalit Health Services in Israel (2008-2012).
  
  
  METHODS
  Interrupted time-series with pre-, during, and postintervention disparities measurement between 55 target clinics (serving approximately 400,000 mostly low socioeconomic, minority populations) and all other (126) clinics.
  
  
  METHODS
  Data on a Quality Indicator Disparity Scale (QUIDS-7) of 7 indicators, and on a 61-indicator scale (QUIDS-61).
  
  
  RESULTS
  The gap between intervention and nonintervention clinics for QUIDS-7 decreased by 66.7 percent and by 70.4 percent for QUIDS-61. Disparity reduction continued (18.2 percent) during the follow-up period.
  
  
  CONCLUSIONS
  Quality improvement can achieve significant reduction in disparities in a wide range of clinical domains, which can be sustained over time.
authors: Clalit Health Services, Tel Aviv, Israel.
authors: Ran D
authors: RD
authors: Balicer
authors: Clalit Research Institute, Chief Physician's Office in Clalit Health Services, Tel Aviv, Israel.
authors: Moshe
authors: M
authors: Hoshen
authors: Clalit Research Institute, Chief Physician's Office in Clalit Health Services, Tel Aviv, Israel.
authors: Chandra
authors: C
authors: Cohen-Stavi
authors: Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
authors: Sivan
authors: S
authors: Shohat-Spitzer
authors: Community Health Division, Clalit Health Services, Tel Aviv, Israel.
authors: Calanit
authors: C
authors: Kay
authors: Clalit Research Institute, Chief Physician's Office in Clalit Health Services, Tel Aviv, Israel.|The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel.
authors: Haim
authors: H
authors: Bitterman
authors: Community Health Division, Clalit Health Services, Tel Aviv, Israel.
authors: Nicky
authors: N
authors: Lieberman
authors: Community Health Division, Clalit Health Services, Tel Aviv, Israel.
authors: Orit
authors: O
authors: Jacobson
authors: Clalit Research Institute, Chief Physician's Office in Clalit Health Services, Tel Aviv, Israel.|Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
authors: Efrat
authors: E
authors: Shadmi
mesh_terms: D006302:Health Services Research; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D065186:Interrupted Time Series Analysis; D007557:Israel; D008913:Minority Groups; D010348:Patient Care Team; D011203:Poverty; D058996:Quality Improvement / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D012959:Socioeconomic Factors
keywords: Health disparities; intervention; quality improvement