TL;DR
- Health inequities cost $320 billion annually in US healthcare spending. That makes measuring equity critical to quality care and cost management
- The most effective frameworks to measure health equity identify disparities, monitor interventions, create accountability, and inform resource allocation
- Some of the leading frameworks include RWJF's Culture of Health, IHI's Achieving Health Equity, and the Equity Weighting Framework
- You need a phased approach to implement these framework successfully. And you need to include leadership buy-in, data collection, integrated metrics and community partnerships
Table of Contents
What's the difference between health equity and health equality?
Health equity isn’t just about what’s right, it’s also about what makes most economic sense. Upstream differences in healthcare funding create downstream costs, to patients’ health and the financial health of caregivers and patients.
There are huge differences in how the $320 billion is spent annually on healthcare in the United States. And it’s only getting worse. We’re trending towards projections of more than $1 trillion by 2040. So for healthcare organizations committed to providing high-quality care and managing costs, health equity measurement systems are a must-have.
A quick recap first, let’s highlight the differences between health equity and health equality.
- Health equity understands:
- Different population segments may have different needs based on gender, socioeconomic status, geography, age, abilities, etc.
- Every individual should have the same opportunity to get the treatment they need to enjoy the highest level of health.
- Health equality means everyone gets the same treatment, regardless of their circumstances.
Why Measure Health Equity?
- It identifies where preventable differences in health outcomes or health disparities exist
- It monitors the effectiveness of interventions aimed at closing health equity gaps
- It creates mechanisms for healthcare systems to be held accountable
- It addresses the social determinants of health guiding resource allocation
- reduced readmissions
- improved patient outcomes, and
- optimized revenue recovery.
What are the leading frameworks for measuring health equity?
Several frameworks have been developed that can successfully help healthcare organizations track health equity criteria and ultimately improve health equity. The three listed below, are some of the most influential frameworks.
Robert Wood Johnson Foundation's Culture of Health Action Framework
Institute for Healthcare Improvement's Achieving Health Equity Framework
- This framework specifically helps healthcare organizations to make health equity a core strategic priority.
- It is based on building supportive internal structures and partnerships with communities.
- It addresses the social determinants of health.
Equity Weighting Framework
- This framework assigns different “weights” to specific patient subgroups.
- This innovative approach addresses the challenges with a majority-group dominating how quality care is measured.
- And it creates financial incentives for providers to improve care for marginalized groups.
What metrics are essential for equity assessment?
- Health outcomes (stratified by demographics)
- Social determinants of health
- Healthcare system performance
Health Outcomes (Stratified by Demographics)
- Mortality rates analyzed by race, ethnicity, and geography
- Chronic disease prevalence and management assessed across demographic groups
- Maternal and infant health outcomes monitored across populations
Social Determinants of Health
- Economic stability indicators (poverty levels, unemployment rates) documented
- Education access and quality metrics reported
- Neighborhood and built environment measures known
- Social and community context indicators tracked
Healthcare System Performance
- Quality and safety measures stratified by race, ethnicity, and socioeconomic status
- Access metrics including appointment wait times and interpretation services availability reported
- Patient experience data analyzed across demographic groups
How can organizations start to implement equity measures?
- Foundational Phase
- Secure leadership commitment
- Establish governance structures
- Improve demographic data collection
- Intermediate Phase
- Stratify key measures
- Develop equity dashboards
- Launch targeted interventions
- Advanced Phase
- Integrate equity metrics into all standard dashboards
- Link progress to incentives
- Build robust community partnerships
Healthcare organizations continue to navigate the complexities of providing high-quality care while managing costs. But they must make health equity central to their plans and operations. They can then not only identify and address disparities but also improve financial performance and patient outcomes.
Qualify Health remains committed to supporting healthcare organizations in this journey. We provide innovative solutions that reduce patient financial burdens, recover revenue, and advance health equity.
