A new tool to track hospital-level disparities

In this volume of The Journal, Parikh et al introduce an important new tool for identifying and tracking hospital- organization-level disparities in healthcare delivery, the Health Disparities Index (HDI). HDI is simple principle easy to understand, as it reports absolute difference between groups a specified metric. After appropriate clinical population, can efficiently compare hospitals or track over time response quality improvement efforts. authors used chest radiographs children aged 5–18 with asthma (which are not recommended) illustrate HDI's use across 36 (Figure). As they note, be applied wide range metrics look based on dimensions addition race ethnicity, including language, gender identity, insurance type. A particular strength lies its reporting groups, rather than 1 group reference another. This feature 2 reasons. first that does assume experience non-Hispanic White patients normative one against which all others should measured. Reports racial ethnic often population conceptualize deviation from “standard.” approach subtly yet powerfully reinforces notion white supremacy. By centering whiteness norm, directs attention magnitude without contributing culture creates them. second reason identify getting sidetracked by discussions over-testing versus under-testing. found were more likely receive non-recommended care, could lead questions whether disparity exists when historically advantaged “bad” care. However, what revealed was wide-spread, systematic pattern differential care ethnicity. Such finding prompt serious inquiry into causes, regardless directionality findings. holds promise help organizations just those sorts patterns efficient way, essential step toward understanding addressing way delivering Article page 290 ▸ Development Index: Proof Concept Chest Radiography AsthmaThe Journal PediatricsVol. 238PreviewTo develop quantifying health (Health Disparity Index[HDI]) explore hospital variation measured index using radiography (CXR) proof concept. Full-Text PDF