Healthcare Quality Improvement: How Well are We Addressing Health Disparities and Inequitable Care?

Twenty-plus years ago, the Institute of Medicine’s report “Crossing the Quality Chasm” positioned equity alongside five other domains of healthcare quality safe, effective, patient-centered, timely, and efficient. Here we explore progress made to address inequities of care through healthcare quality improvement and outline various priorities for 2022 and beyond.

In a recent editorial in BMJ, Dr. Lisa Hirschhorn and colleagues suggested three potential outcomes of healthcare quality improvement strategies on health equity:
 

• Equality in improvement for all, but there remain equity gaps
• Decreasing equity gaps
• Widening equity gaps

While evidence varies on the Impact of healthcare quality improvement strategies, policies, and initiatives to reduce inequity in care, there are clear areas of progress as well as critical improvements to maintain momentum toward desired outcomes. Figure 2 maps many of the current healthcare quality improvement strategies and whether they are provider-focused, payer-focused, or include both payers and providers.