Bruce E. Landon, MD, MBA, an associate professor of health care policy at Harvard Medical School, is the lead author of a study that was recently published in the prestigious New England Journal of Medicine. The study focused on quality-improvement initiatives in community health centers that participate in the Health Disparities Collaboratives, a program of the US Health Resources and Services Administration. These collaboratives are designed to improve care for chronic medical conditions by focusing on specific quality-improvement interventions in each center that, if proved successful through testing, are then disseminated throughout the health center.
Landon and colleagues carried out the first controlled study of the changes brought about by community health centers’ participation in the Health Disparities Collaboratives. They evaluated quality-improvement activities for three chronic medical conditions: diabetes, asthma, and hypertension.
The researchers found that, compared with control centers, the centers in the collaboratives showed significantly greater improvement in care for asthma and diabetes, but not for hypertension. The results also showed that the collaborative centers had no improvement in intermediate clinical outcomes for the diseases. “Systematic evaluations of quality-improvement initiatives are important,” says Landon, “because health care institutions need better data on the best ways to use their scarce resources devoted to quality improvement.”
The abstract of the article, entitled, "Improving the Management of Chronic Disease at Community Health Centers,” is available at the New England Journal site. Click here for the full text.
Landon is also the second author of a study comparing emergency room visits by individuals who switched to a high-deductible health plan with a control group who remained in a traditional health maintenance organization. The article, "Emergency Department Use and Subsequent Hospitalizations Among Members of a High-Deductible Health Plan," was published in the March 14 issue of the Journal of the American Medical Association. The abstract is available at the JAMA website.
