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|Issue 99||July 2015|
Evidence Brief: Racial and Ethnic Disparities Within VA
A recent Evidence-based Synthesis Program Coordinating Center (ESP CC) rapid review of evidence on racial and ethnic differences in outcomes for VA patients found moderate- and low-strength evidence to suggest gaps in morbidity and mortality outcomes among vulnerable Veteran populations with major conditions. (A partial listing of the moderate- and low-strength evidence appears in Table A. See the full Evidence Brief for other outcomes with moderate-, low-, and high-strength evidence.) The report also found that the few interventions that have improved racial/ethnic disparities within the VA have focused primarily on African Americans and have covered a narrow scope of clinical areas.
As part of its mission to advance health equity, the Veterans Health Administration (VHA) Office of Health Equity (OHE) is partnering with the Quality Enhancement Research Initiative (QUERI) to evaluate gaps in morbidity and mortality outcomes and to examine trends in quality of care across these conditions. To help inform selection of operational and research priorities for the Partnered Evaluation Center (PEC), the OHE requested that the ESP CC provide an evidence brief update on what research and implementation priorities have emerged since (1) the 2007 ESP publication "Racial and Ethnic Disparities in the VA Healthcare System" that reviewed in which clinical areas racial and ethnic disparities are prevalent within the VA, and (2) the 2011 ESP review "Interventions to Improve Minority Health Care and Racial and Ethnic Disparities."
Because this was an evidence brief with a shortened timeline (as opposed to a full systematic review), only studies of race- and ethnicity-based mortality and morbidity differences were evaluated; these are key areas of the OHE's -priority indicators of health care quality. The sources of differences were not evaluated. A disparity was defined as "any instance of worse mortality or morbidity outcomes for the racial/ethnic minority groups."
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This report is a product of VA/HSR&D's Quality Enhancement Research Initiative's (QUERI) Evidence-Based Synthesis Program (ESP). ESP is currently soliciting review topics from the broader VA community. Nominations will be accepted electronically using the online Topic Submission Form. If your topic is selected for a synthesis, you will be contacted by an ESP Center to refine the questions and determine a timeline for the report.
This Management e-Brief is provided to inform you about recent HSR&D findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR&D Resource Center charged with disseminating important HSR&D findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.
This report is a product of VA/HSR&D's Quality Enhancement Research Initiative's (QUERI) Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers – and to disseminate these reports throughout VA.
See all reports online.