Home > Publications . Search All . Browse All . Country . Browse PSC Pubs . PSC Report Series

PSC In The News

RSS Feed icon

Frey and colleagues outline 10 trends showing scale of America's demographic transitions

Starr says surveys intended to predict recidivism assign higher risk to poor

Prescott and colleagues find incidence of noncompetes in U.S. labor force varies by job, state, worker education

Highlights

PAA 2015 Annual Meeting: Preliminary program and list of UM participants

ISR addition wins LEED Gold Certification

PSC Fall 2014 Newsletter now available

Martha Bailey and Nicolas Duquette win Cole Prize for article on War on Poverty

Next Brown Bag

Mon, March 9
Luigi Pistaferri, Consumption Inequality and Family Labor Supply

Improving Care for Minorities: Can Quality Improvement Interventions Improve Care and Outcomes for Depressed Minorities? Results of a Randomized, Controlled Trial

Archived Abstract of Former PSC Researcher

Miranda, J., N.H. Duan, C. Sherbourne, Michael Schoenbaum, I. Lagomasino, M. Jackson-Triche, and K.B. Wells. 2003. "Improving Care for Minorities: Can Quality Improvement Interventions Improve Care and Outcomes for Depressed Minorities? Results of a Randomized, Controlled Trial." Health Services Research, 38(2): 613-630.

Objective. Ethnic minority patients often receive poorer quality care and have worse outcomes than white patients, yet practice-based approaches to reduce such disparities have not been identified. We determined whether practice-initiated quality improvement (QI) interventions for depressed primary care patients improve care across ethnic groups and reduce outcome disparities. Study Setting. The sample consists of 46 primary care practices in 6 U.S. managed care organizations; 181 clinicians; 398 Latinos, 93. African Americans, and 778 white patients with probable depressive disorder. Study Design. Matched practices were randomized to usual care or one of two QI programs that trained local experts to educate clinicians; nurses to educate, assess, and follow-up with patients; and psychotherapists to conduct Cognitive Behavioral Therapy. Patients and physicians selected treatments. Interventions featured modest accommodations for minority patients (e.g., translations, cultural training for clinicians). Data Extraction Methods. Multilevel logistic regression analyses assessed intervention effects within and among ethnic groups. Principal Findings. At baseline, all ethnic groups (Latino, African American, white) had low to moderate rates of appropriate care and the interventions significantly improved appropriate care at six months (by 8-20 percentage points) within each ethnic group, with no significant difference in response by ethnic group. The interventions significantly decreased the likelihood that Latinos and African Americans would report probable depression at months 6 and 12; the white intervention sample did not differ from controls in reported probable depression at either follow-up. While the intervention significantly improved the rate of employment for whites and not for minorities, precision was low for comparing intervention response on this outcome. It is important to note that minorities remained less likely to have appropriate care and more likely to be depressed than white patients. Conclusions. Implementation of quality improvement interventions that have modest accommodations for minority patients can improve quality of care for whites and underserved minorities alike, while minorities may be especially likely to benefit

Browse | Search : All Pubs | Next