Strategies for improving minority healthcare quality

Beach MC, Cooper LA, Robinson KA, Price EG, Gary TL, Jenckes MW
Record ID 32004000659
Authors' objectives:

We performed a systematic review of evidence concerning the effectiveness of interventions designed to improve the quality of healthcare in racial or ethnic minorities. Our report focused on evaluations of interventions targeted at healthcare providers or organizations, as provider and organizational factors contribute substantially to disparities and inequities in access to and quality of healthcare.

Authors' results and conclusions: Ninety-one articles were identified. Twenty-seven articles evaluated strategies targeted at healthcare providers or organizations to improve minority healthcare quality. The majority of these studies targeted physicians and most addressed aspects of prevention. There is excellent evidence that tracking/reminder systems can improve quality of care, and fair evidence that multifaceted interventions, provider education interventions, and interventions that bypass the physician to offer screening services to racial/ethnic minority patients can improve quality of care. Sixty-four articles evaluated cultural competence training as a strategy to improve the quality of healthcare in minority populations. Curricula addressed specific or general concepts of culture and were primarily group discussions and lectures. The lack of consistency in intervention methods and measured outcomes limited the evidence synthesis. There is, however, excellent evidence for improvement in provider knowledge, good evidence for improvement in provider attitudes and skills, and good evidence for improvement in patient satisfaction.
Authors' recommendations: There is some evidence that interventions to improve quality of healthcare for minorities, including cultural competence training, are effective. More research is needed on quality improvement interventions specifically designed to reduce disparities. For example, interventions should target conditions and healthcare processes for which disparities have been documented. Also needed is more research on cultural competence training that uses rigorous study designs, well-described interventions and measurable objectives that are linked to process and outcome variables. Valid, reliable, and objective measurement of cultural competence is needed. As the literature grows, this information needs continued systematic review, updated on a regular basis and disseminated to clinicians, other healthcare decision-makers, educators, and the medical and health services research community.
Authors' methods: Systematic review
Project Status: Completed
Year Published: 2004
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
MeSH Terms
  • Quality of Health Care
Organisation Name: Agency for Healthcare Research and Quality
Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name:
Contact Email:
Copyright: Agency for Healthcare Research and Quality (AHRQ)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.