Equity in the Distribution of Quality of Care

Wyszewianski, Leon; Donabedian, Avedis

doi:10.1097/00005650-198112001-00005

Cited by 28 publications

(9 citation statements)

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“…Mackillop highlights a sixth dimension, awareness [19]. Equitable access to cancer control in developing countries is a prerequisite to equitable quality of care [20]. …”

Section: Discussionmentioning

confidence: 99%

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

Hanna¹,

Kangolle

2010

BMC Int Health Hum Rights

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BackgroundCancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas.DiscussionThis article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes.SummaryThere is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important.

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“…Mackillop highlights a sixth dimension, awareness [19]. Equitable access to cancer control in developing countries is a prerequisite to equitable quality of care [20]. …”

Section: Discussionmentioning

confidence: 99%

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

Hanna¹,

Kangolle

2010

BMC Int Health Hum Rights

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“…It is also relevant to ask whether, once a treatment has been selected, African‐American men receive comparable QoC to their Caucasian counterparts [39]. If, in fact, African‐Americans receive inferior QoC, this would represent a potentially modifiable source of racial disparities in prostate cancer care and would reveal an opportunity to correct an injustice and to reduce the extra costs associated with low‐QoC.…”

Section: Qoc‐metrics In Prostate Cancer Treatmentmentioning

confidence: 99%

“…In the early 1980s, Wyszewianski and Donabedian [39] wrote, ‘structural inequities are present whenever certain groups receive a greater proportion of their care from individual providers or healthcare organizations that are either not optimal or are inappropriate for the needs of the individual persons within the group.’ However, there have been few studies of structural inequities in prostate cancer care to date.…”

Section: Racial Disparities In Quality: Structural Inequitiesmentioning

confidence: 99%

Racial variation in the pattern and quality of care for prostate cancer in the USA: mind the gap

Barocas

Penson

2010

BJU International

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This is a comment moderated paper. Please go to http://www.bjuicommentary.com for further details. OBJECTIVE To review the literature on racial variation in the pattern of care (PoC) and quality of care (QoC) for prostate cancer, as there are known racial disparities in the incidence and outcomes of prostate cancer. While there are some biological explanations for these differences, they do not completely explain the variation. Differences in the appropriateness and QoC delivered to men of different racial groups may contribute to disparities in outcome. METHODS We searched the USA National Library of Medicine PubMed system for articles pertaining to quality indicators in prostate cancer and racial disparities in QoC for prostate cancer. RESULTS While standards for appropriate treatment are not clearly defined, racial variation in the PoC has been reported in several studies, suggesting that African‐American men may receive less aggressive treatment. There are validated QoC indicators in prostate cancer, and researchers have begun to evaluate racial variation in adherence to these quality indicators. Further quality comparisons, particularly in structural measures, may need to be performed to fully evaluate differences in QoC. CONCLUSIONS There is mounting evidence for racial variation in the PoC and QoC for prostate cancer, which may contribute to observed differences in outcome. While some of the sources of racial variation in quality and outcome have been identified through the development of evidence‐based guidelines and validated quality indicators, opportunities exist to identify, study and attempt to resolve other components of the quality gap.

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“…Indeed, various authors have noted the multiple factors leading to inter-group variations in health-care utilization as well as to the different outcomes of such uses (2,9,10,19). Indeed, various authors have noted the multiple factors leading to inter-group variations in health-care utilization as well as to the different outcomes of such uses (2,9,10,19).…”

Section: Introductionmentioning

confidence: 99%

Inequity in health a case study

Ellencweig

Grafstein

1989

Eur J Epidemiol

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This article presents a particular case of inequity in health, that of two types of Israeli urban settlement: development towns and veteran towns. Inequity in health is demonstrated by the varying levels of resources allocated to each type of community, by the differences in health-care utilization (process), and by the diversity of external factors affecting the two categories of towns. Despite the existence of almost universal health insurance coverage in Israel, it is shown that inhabitants of less privileged development towns are more prone to inequitable health outcomes with respect to the wealthier populations living in veteran towns. This case illustrates an integrated approach to inequity in health, including the health-care system structure, utilization patterns, and the socio-demographic-economic background of different strata.

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Equity in the Distribution of Quality of Care

Cited by 28 publications

References 0 publications

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

Racial variation in the pattern and quality of care for prostate cancer in the USA: mind the gap

Inequity in health a case study

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