EDITION ALREADY GRADED A+
DONABEDIAN FRAMEWORK
Outcome- Patient, organizational, Community of environmental
-infection rates
-rates of rehospitalization
-patient satisfaction
Vulnerable porpulations
-racial and ethnic minorities
-children
-women
-unisured
-people living in rural areas
-homeless
-medically ill
-chronically ill and disabled
-HIV/AIDS
Predisposing characteristics
-race/ethnicity
-gender/age
-geographic location
Enabling characteristics
-unisured
-homelessness
Need characteristics
-mental health
-chronic illness/diability
-HIV/AIDS
Factors that contribute to vulnerability
-harmful health behaviors: acohol, smoking, violence
-Issues with access to care and quality care: financial, educations, language, geographic
-discrimination based on race/gender/sexual presference
Race
relates to a person's appearance. It is determined biologically with genetic traits. eye color, skin color,
hair color
, Ethnicity
cultural factors: nationality, culture, ancestry, language and beliefs.
Sex
defined biologically & physically
Gender
socially constructed and framed as an extension of biologically determined social functions.
Difference
racial/ethnic inequality that is not explained by access-related factors
Disparity
racial/ethnic differences in quality of healthcare that are not due to access related factors or clinical
needs, preferences and appropriateness of intervention
Discrimination
differences in care that result from biases, prejudice, stereotyping and uncertainty in clinical
communications and decision making.
Health care factors that contribute to disparity
-availability of unterpreters
-availabilty of physicians, technology and drugs in certain geographical areas
-cost control strategies by hospitals
-decreased funding for free clinics
Steretyping
process by which people use social categories in acquiring, processing and recalling information
prejudice
an unjustified negative attitude based on a person's group membership
bias
acting on prejudice
cultural competency
(awareness, knowledge & sensitivity)
a health system that acknowledges and incorporates the importance of culture, assessment of cross-
culture relations, vigilance toward the dynamics that result from cultural differences, expansion of
cultural knowledge and adaption of service to meet culturally unique needs.
ACA effect on disparities