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Disparities in Medical Practices

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Medical Practice Variations

Part of the book series: Health Services Research ((HEALTHSR))

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Abstract

Inequities in health associated with socioeconomic position including income, education, race/ethnicity, gender, and geography are found across societies internationally. Inequities/disparities in health system performance associated with socioeconomic position have also been widely documented. This chapter provides an overview of variations in health and health care associated with socioeconomic position. Methods of measuring health disparities and measurement challenges commonly encountered are discussed. Populations at risk for health inequities include any group consistently more likely to experience poor health than the general population as consequence of social or economic disadvantage. Studying disparities begins with reliable and valid measures and methods for tracking change over time. Important concepts to consider include how the use of relative and absolute disparities may result in different estimates of changes in disparity over time, how the choice of reference group can affect perceptions of disparities, when to use rate comparisons or summary measures, and whether to stratify or risk adjust measures. Objectives for the analysis should inform decisions about indicator choice and measurement. Then, results need to be interpreted in the context of the specific strengths and limitations of the measurement approach used. Health inequities result in enormous costs for individuals, health systems, communities, and governments. Much can be gained by interventions aimed at reducing and ultimately eliminating them. This chapter focuses primarily on measurement and reporting challenges. The same concepts are applicable to studies to better understand factors that lead to more or less equitable health outcomes or to evaluate interventions designed to reduce disparities.

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Authors and Affiliations

  1. Li Ka Shing Knowledge Institute and St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada

    Arlene S. Bierman

  2. Department of Health Care Policy, Center for Surgery and Public Health, Brigham and Women’s Hospital/Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115, USA

    Joel S. Weissman

Authors
  1. Arlene S. Bierman
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  2. Joel S. Weissman
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Correspondence to Arlene S. Bierman .

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Editors and Affiliations

  1. DptofPublHlthSci,InstfrClnclEvltSciQueen, CntrforHlthServs&PolicyRsrch,Queen'sUniv, Kingston, Canada

    Ana Johnson

  2. Institute forClinical EvaluativeSciences, Toronto, Ontario, Canada

    Thérèse A. Stukel

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Bierman, A.S., Weissman, J.S. (2016). Disparities in Medical Practices. In: Johnson, A., Stukel, T. (eds) Medical Practice Variations. Health Services Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7603-1_68

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