Designing a Health Equity Index to Improve the Patient Experience
Empowering Health Care Consumers
April 30, 2021
For NYSHealth, health equity is achieved when all people have the opportunities and resources they need to be as healthy as possible and no one is disadvantaged.
But in practice, patients—particularly people of color—are often marginalized rather than placed at the center of the health care system. Although all patients should be valued as partners, patients of color can face unique obstacles, including racism, bias, mistrust, and gaps in communication between patients and physicians. Engaging patients of color is an important step toward the development of a more equitable health system. To help ensure that patients’ priorities, preferences, and experiences guide efforts to create a more equitable health care system, NYSHealth issued a Request for Proposals (RFP), “Patients as Partners: Advancing Equity.” Through this RFP, NYSHealth is supporting projects that seek to implement system improvements, practice innovations, or interventions designed to give patients of color a meaningful role in their health care. In 2021, NYSHealth awarded the Research Foundation for SUNY, on behalf of SUNY Downstate Health Sciences Center (DHSU), a grant to participate in this initiative.
Under this grant, DHSU will develop an index to measure and address racial inequities in the patient experience. Typically, patients of color have lower rates of visit satisfaction, shorter visit times, less quality communication, less comprehensive and preventive counseling, and less participatory decision-making. DHSU will partner with One Brooklyn Health System (OBHS), which serves nearly 1.2 million mostly black and brown patients, and Arthur Ashe Institute for Urban Health to develop the Central and Northeast Brooklyn Health Equity Index, a comprehensive survey tool to collect relevant data that current patient-surveying methods do not capture. Patients and community stakeholders will be enlisted to define, design, and develop ways of measuring patient experience using health equity measures for the index. Themes to be explored will include discrimination in the health care setting; patient safety and security; medical mistrust; provider responsiveness; implicit bias; cultural sensitivity; provider understanding of social determinants; structural racism; patient access; and family/caregiver experiences. OBHS will integrate the index into its routine patient experience and system performance and quality improvement evaluations. Findings will be used to compare performances across OBHS’ health systems and to improve health care equity and shared decision-making with patients. In collaboration with its partners, DHSU will also broadly disseminate the tool and its data to other health care systems and providers in New York State to encourage replication.