Parikh et al reported a health disparities index (HDI) to help screen for help disparities in healthcare delivery. The authors are from multiple institutions from around the United States.
Parameters:
(1) percentage of patients in racial/ethnic group A getting service
(2) percentage of patients in racial/ethnic group B getting service
(3) percentage of patients in racial/ethnic group C getting service
(4) percentage of patients in racial/ethnic group D getting service
health disparities index =
= MAX(various racial/ethnic groups) - (MIN(various racial/ethnic groups)
Interpretation:
• The higher the HDI the greater the disparity.
• To have significance the analysis needs to control for all of the other variables impacting care.
Comment: The study was done in pediatric patients with asthma. In this group the guideline does not recommend chest X-ray in children > 5 years. The group with the lower level of service (i.e., did not get an X-ray) would seem to be more appropriate care.
A modification of the score therefore might be to determine for each racial/ethnic group:
(1) who got appropriate care for the guideline (did not need service and did not get; needed service and got it).
(2) who was overtreated or received unnecessary care (did not need service but got it)
(3) who was undertreated or received insufficient care (needed service and did not get it)