ABSTRACT
Objective: Health equity is greatly impacted by the systems and processes with which
health systems deliver care. Given the minimal guidance on measurement and reporting
of health inequities specific to key population health outcomes, a solution for measurement
of health equity is proposed.
Materials and Methods: The concept of a lens of equity was adopted to disaggregate
common measures such as breast cancer screening rates in order to expose inequities
across neighborhoods and races in populations served. Two lenses of equity were introduced
into the corporate measurement systems, race/ethnicity as measured in the electronic
health record, and a surrogate measure of family income.
Results: An Equity category wasadded to our measurement systems and counted towards
our corporate goals (“system scorecards”) along with data insights and discovery
tools to support the efforts of the breast cancer screening improvement teams. Over
a one-year timeframe, Endeavor Health not only met but exceeded its breast cancer
screening equity goal, increasing mammography adherence from 73% to 82.6% among residents
in the lowest income neighborhoods served.
Discussion:
The analytics and data systems that support complex healthcare measurement tools require
diligent and thoughtful design to meet external reporting requirements and support
the internal teams who aim to improve the care of populations served.
Conclusions: The analytic approach presented may be readily extended to populations
with other potentially impactful differences in social determinants and health status.
A “lens-of-equity” tool may be established along similar lines, allowing policy and
strategy initiatives to be appropriately targeted and successfully implemented.
