Disparity Documentation Reports and Improvement Plans

Disparity Final Report – September 2017

The final report for the 1115 Waiver extension year is to update the three disparities identified in the past five years, report the new activities accomplished in the last year (10/01/2016~09/30/2017), and summarize the lessons learned from this project. The report focuses on how a project is carried out to make positive impacts on the health system (i.e. building electronic health records) which allows for academic research, clinical decision making, and institutional strategic planning.

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Disparity Documentation Report 3 – September 2016

This 3rd Disparities Documentation Report focuses on describing type 2 diabetes (T2D) burden that disproportionately affected racial minorities served by UTMB. In particular, the report found that African American patients were more likely to have comorbidities and complications related to T2D. This report also updated the quality performance presented in the previous two Disparity Documentation Reports (March 2015 and March 2016). The report suggests that length of stay for heart failure patients is decreasing but the readmission rate is increasing among African American patients. Finally, this report pointed out that low birthweight disparities were significantly reduced.

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Improvement Plan 3 – September 2016

This 3rd Improvement Plan focuses on recommendations to support patients better manage their chronic conditions such as heart failure and T2D. It also provides suggestions to providers including enhancing their understanding of social determinants of health related to health disparities. Third, it proposes several strategies for institutions and organizations including engaging different stakeholders, identifying community resources, coordinating non-health services, and so on.

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Disparity Documentation Report 2 – March 2016

This 2nd Disparities Documentation Report illustrates and discusses three health disparities in UTMB patients admitted across a three-year period (January 1st, 2012 to December 31st, 2014). In addition, it provides updates to the disparities reported in March 2015. The accompanying document (2nd Improvement Plan) suggests and discusses recommendations to address the three identified disparities in patients admitted with heart failure.

Heart Failure is one of the leading causes of hospitalization and readmission in the US. It affects 5.7 million people with around half million new annual cases. It contributes to immature death of 55,000 annually. The economic burden of heart failure is high with a direct cost of $34.4 billion. Hospitalization for heart failure accounts for half of the total costs for heart failure

Among five measures, there was no disparity found in direct cost and mortality. However, the analysis suggests that African Americans are more likely to have combined heart failure (both systolic and diastolic), longer length of stay, and higher 6-month readmission rates compared to White and Hispanic patients.

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Improvement Plan 2 – March 2016

This improvement plan aims to address three racial disparities observed among UTMB patients admitted with heart failure as a primary diagnosis across a three-year period (January 1st, 2012 to December 31st, 2014). The REAL Data Project research team finds that, compared to White and Hispanic patients admitted with heart failure, African American patients admitted with heart failure have a (1) higher percentage of combined (systolic and diastolic) heart failure, (2) higher rate of 6-month readmissions, and (3) longer average length of stay.

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Disparity Documentation Report 1 – March 2015

      Disparities Report of 2015: The 1st Disparities Report identified three race/ethnic disparities in low birthweight, breastfeeding rate, and avoidable ambulatory care sensitive admissions (including asthma, diabetes, heart failure, hypertension, angina, chronic obstructive pulmonary diseases, and grand mal-status and other epileptic convulsions). The REAL Data project team conducted multiple tests using outpatient and inpatient data from University HealthSystem Consortium (UHC) and Texas Health Care Information Collection (THCIC). While most quality measures indicate the high quality of care provided by UTMB, we found out that African American patients experienced disparities in three measures.

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Improvement Plan 1 – March 2015

Improvement Plan of 2015: To address three disparities identified, the REAL Data project team recommends 18 multi-level strategies that would engage interdisciplinary stakeholders. In addition, we envision the strategies to be implemented according to four stages: dissemination and dialogue, bridging silos and educating leaders, convening a Disparities Committee, and creating a Disparities Dashboard.

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