The current report is the second of two related papers commissioned by Health and Human Services. The first paper outlined the research challenges and techniques of studying multiple chronic conditions, with an emphasis on studying the “long tail” of the distribution of multiple chronic conditions (Rezaee, et.al. 2013). There are many unique combinations of chronic conditions with a relatively small number of people experiencing each combination. Any one provider or insurer will have a subset of patients with a particular combination, making it difficult to study or develop optimal care plans for each group of patients.
The purpose of the study is to assess the existing data sources and methods that can be used to investigate disparities and MCC. The paper is intended to serve as a resource for investigators working on disparities MCC with a goal of identifying promising areas for research, data sources and methods. The information can help both researchers and stakeholders better understand and interpret research results, as well as consider what steps might be taken in the future to improve the knowledgebase on health care for MCC. It may also be useful to researchers implementing the National Strategic Disparities Plans produced by other agencies and stakeholders (See Exhibit 2).
The white paper addresses the following questions:
- What combinations of comorbidities are most critical in terms of identifying opportunities for targeting and reducing disparities in care utilization and cost in MCC adult populations?
- What data systems and datasets exist that can be analyzed to better improve our understanding of and approaches to addressing disparities in MCC adult populations?
Exhibit 2: National Strategic Disparities Plans
|HHS Agency/ Organization||Title||Year||Summary||Citation|
|Agency for Healthcare Research and Quality (AHRQ)||National Healthcare Disparities Report||2012||Highlights healthcare access for racial and ethnic groups from 2002–2008.||Agency for Healthcare Research and Quality. (2013). 2012 National Healthcare Disparities Report. Rockville, MD.|
|Centers for Disease Control and Prevention (CDC)||CDC Health Disparities and Inequalities Report – United States, 2011||2011||Consolidates national data on disparities in mortality, morbidity, behavioral risk factors, healthcare access, preventive health services, and social determinants of critical health problems in the US.||Centers for Disease Control and Prevention. (2011). CDC Health Disparities and Inequalities Report – United States, 2011. Morbidity and Mortality Weekly Report,60 (Suppl),1-114.|
|Institute of Medicine (IOM)||How Far Have We Come in Reducing Health Disparities?: Progress Since 2000: Workshop Summary||2012||Summarizes an IOM workshop on April 8th, 2010 during which progress to address health disparities through a number of federal initiatives was discussed.||IOM Institute of Medicine. (2012). How far have we come in reducing health disparities: Progress since 2000: Workshop summary. Washington, D.C.: The National Academies Press.|
|National Institutes of Health (NIH)||NIH Health DisparitiesStrategic Plan and Budget Fiscal Years 2009-2013||2009||Details the major priorities and NIH initiatives currently being undertaken to eliminate health disparities.||National Institutes of Health. NIH Health Disparities Strategic Plan and Budget Fiscal Years 2009-2013. U.S. Department of Health and Human Services, Bethesda, MD.|
|National Partnership for Action to End Health Disparities (NPA)||HHS Action Plan to Reduce Racial and Ethnic Health Disparities National Stakeholder Strategy for Achieving Health Equity||2011||Outlines goals and actions HHS will take to reduce health disparities among racial and ethnic minorities.||U.S. Department of Health and Human Services. (2011). HHS Action Plan to Reduce Racial and Ethnic Disparities: A Nation Free of Disparities in Health and Health Care. Washington, DC.|
|National Partnership for Action to End Health Disparities (NPA)||National Stakeholder Strategy for Achieving Health Equity||2011||Provides a common set of goals and objectives for public and private sector initiatives and partnerships to help racial and ethnic minorities–and other underserved groups – reach their full health potential.||National Partnership for Action to End Health Disparities. (2011). National Stakeholder Strategy for Achieving Health Equity. Rockville, MD: U.S. Department of Health & Human Services, Office of Minority Health.|