Health care quality and disparities and the health care provider: what we can do.

he current debate about health care reform has centered primarily on controlling the cost of health care and health insurance access. The third essential component of health policy — health care quality — must be addressed as well. Despite a lack of media attention, health care quality initiatives are significant components of health care reform. However, racial and ethnic health care disparities receive much less attention in discussions of health care reform and quality. This debate represents an opportunity for health care providers to address health care quality for all Arkansans. HEALTH CARE QUALITY AND HEALTH CARE DISPARITIES Quality health care in the United States should be safe, effective, patient-centered, timely, efficient and equitable. Equitable health care is care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location , and socioeconomic status. While the U.S. spends 16.2% of its GDP on health care, our health care delivery system does not provide consistent, high-quality medical care to all people. " Indeed, between the health care that we now have and the health care that we could have lies not just a gap, but a chasm. " 1 Racial and ethnic minorities fall into this chasm. Eliminating racial and ethnic health disparities is a key component of improving health care quality in the United States. Racial and ethnic health disparities are defined as differences in the incidence and prevalence of disease, access to health care, quality of care or health outcomes by racial/ethnic subgroups. There has been extensive documentation of racial and ethnic health disparities over time and across many disease states. The cause of these disparities is a complex interaction of social, economic, community, behav-ioral and health care system factors. with low incomes, at least 60% of measures of quality of care either stayed the same or worsened. 2 A report from the Institute of Medicine found that minority patients are less likely than whites to receive the same quality of health care, even when they have similar insurance or ability to pay for care. 3 It also identified three potential sources of health care disparities: n Health care systems, hospitals, and clinics may adopt policies or practices that are based on good intentions but may harm minority patients' ability to access care. n Some minority patients do not trust health care professionals, and so may put off seeing a doctor until their illness …