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

PSC In The News

RSS Feed icon

Frey's Scenario F simulation mentioned in account of the Democratic Party's tribulations

U-M Poverty Solutions funds nine projects

Dynarski says NY's Excelsior Scholarship Program could crowd out low-income and minority students

More News

Highlights

Workshops on EndNote, NIH reporting, and publication altmetrics, Jan 26 through Feb 7, ISR

2017 PAA Annual Meeting, April 27-29, Chicago

NIH funding opportunity: Etiology of Health Disparities and Health Advantages among Immigrant Populations (R01 and R21), open Jan 2017

Russell Sage 2017 Summer Institute in Computational Social Science, June 18-July 1. Application deadline Feb 17.

More Highlights

Next Brown Bag

Mon, Jan 23, 2017 at noon:
Decline of cash assistance and child well-being, Luke Shaefer

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