A Summary Measure of Health Inequalities for a Pay-for-Population Health Performance System

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Asada, Yukiko
• Description:
  A system that rewards population health must be able to measure and track health inequalities. Health inequalities have most commonly been measured in a bivariate fashion, as a joint distribution of health and another attribute such as income, education, or race/ethnicity. I argue this practice gives insufficient information to reduce health inequalities and propose a summary measure of health inequalities, which gives information both on overall health inequality and bivariate health inequalities. I introduce 2 approaches to develop a summary measure of health inequalities. The bottom-up approach defines attributes of interest, measures bivariate health inequalities related to these attributes separately, and then combines these bivariate health inequalities into a summary index. The top-down approach measures overall health inequality and then breaks it down into health inequalities related to different attributes. After describing the 2 approaches in terms of building-block measurement properties, aggregation, value, data and sample size requirements, and communication, I recommend that, when data are available, a summary measure should use the top-down approach. In addition, a strong communication strategy is necessary to allow users of the summary measure to understand how it was calculated and what it means.
• Subjects:
  Health Status Disparities Health Status Indicators Humans Models, Statistical Outcome Assessment (Health Care) Reimbursement, Incentive
• Source:
  Prev Chronic Dis. 7(4).
• ISSN:
  1545-1151
• Document Type:
  Journal Article
• Genre:
  Special Topic
• Volume:
  7
• Issue:
  4
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:824a3cef5728c6a4598df61c30c640d041c818170d8eafe091b3165bec150bbf84519006d82918213821451d60e2bf53c901d56ba1dac41c862e00114980cf80
• Download URL:
  https://stacks.cdc.gov/view/cdc/20475/cdc_20475_DS1.pdf
• File Type:
  [PDF - 415.75 KB ]