Advancing Measurement of Equity and Patient-Centered Care to Improve Health Care Quality

An RWJF National Program

Field of Work: Expanding understanding of how to make health care more patient-centered and more equitable.

Problem Synopsis: In its inventory of available data about quality improvement, RWJF found few evidence-based approaches on two important topics: how to make health care more patient-centered and how to make it more equitable. The Foundation sought to improve understanding of how to measure equity and patient-centered care and the role of both in promoting quality.

Synopsis of the Work: RWJF awarded 17 grants for research projects in three categories: Patients' Experience with Care and Survey Instruments (nine grants), Patients' Decision-Making Processes (four grants) and the Use of "Decision Aids" by Patients and Clinicians (four grants).

Key Results

  • Projects on Patients' Experience with Care and Survey Instruments evaluated the use of surveys from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and the Experience of Care and Health Outcomes (ECHO™) Survey with racially and ethnically diverse populations.

    Examples of issues addressed included the extent to which the surveys capture aspects of health care encounters that members of different racial/ethnic groups rate as most important to quality, and the applicability of the surveys for use with Native-American health care consumers.

    Projects on Patients' Decision-Making Processes investigated patient perceptions of the risks and benefits of different courses of action in different health care conditions. Researchers studied the process of choosing a hospital and patients’ use of personalized risk information, among other issues.

    Projects on the Use of "Decision Aids" by Patients and Clinicians focused on the development, use and evaluation of tools that assist patients and their providers in working together to make treatment decisions. Specific projects addressed video behavior support for diabetes self-care and the use of interpreted shared decision-making with Latino patients screened for prostate cancer, for example.