"From the standpoint of hospitals – it's really critical that they begin to measure quality by race and ethnicity. And to do that they will need to create race and ethnicity data, and that links to the communication piece," Betancourt says. "If you look at race and ethnicity, you can look at where the gaps are and where you might intervene."
"I think what we are seeing now is a sporadic collection of this information," Betancourt adds. "Even those (hospitals) that are collecting race and ethnicity data, for example, few are linking it to quality measurement."
Certainly, there have been many reports over the years, raising the question of disparity issues and what needs to be done, including the Institute of Medicine's report, Unequal Treatment,' are a treasure trove of reports over the years, on the disparity issue.
The Centers for Disease Control and Prevention recently released "Research to Practice: Building Our Understanding," a series of reports that focuses on health communication practices that address topics ranging the most effective ways to communicate with the Hispanic and Latino communities to helping users apply effective evaluation strategies, as my colleague Alexandra Wilson Pecci wrote about last month.
Communication problems are most frequently the cause of serious adverse events, compromised by language barriers, cultural differences, and low health literacy. The result is increased length of stays, Betancourt says.
Because of communication difficulties, providers may tend to order expensive tests such as CT scans for conditions that could otherwise be diagnosed, Betancourt says. Minority populations are more likely to be readmitted for certain chronic conditions such as congestive heart failure than their white counterparts, he adds.
Dealing with communication and disparities issues begins at the C-suite, Betancourt says. The Disparities Solutions Center, which Betancourt heads, which is dedicated to development and implementation of to eliminate racial and ethnic disparities, and provides leadership training to do so. The DSC opened in 2005, with initial funding from Massachusetts General Hospital and the Partners Health Care system, and is affiliated with MGH and the Harvard Medical School's department of medicine. It issued a guide for hospital leaders about disparity issues, such as diabetes management, and highlights practices to address the issues.