Advancing Health Disparities Research Within the Health Care System: A Conceptual Framework
Amy M. Kilbourne 1*,Galen Switzer 1,Kelly Hyman 1,Megan Crowley-Matoka 1,Michael J. Fine 1
1 VA Pittsburgh Healthcare System
* To whom correspondence should be addressed. E-mail: amy.kilbourne{at}med.va.gov.
Abstract
We provide a framework for health services-related researchers,practitioners, and policy makers to guide future health disparitiesresearch in areas ranging from detecting differences in healthand health care to understanding the determinants that underliedisparities to ultimately designing interventions that reduceand eliminate these disparities. To do this, we identified potentialselection biases and definitions of vulnerable groups when detectingdisparities.
The key factors to understanding disparities weremultilevel determinants of health disparities, including individualbeliefs and preferences, effective patient-provider communication;and the organizational culture of the health care system. Weencourage interventions that yield generalizable data on theireffectiveness and that promote further engagement of communities,providers, and policymakers to ultimately enhance the applicationand the impact of health disparities research.
Key Words:
Health Care Facilities/Services, Quality of Care, Health Service Delivery, Race/Ethnicity, Socioeconomic Factors
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