U.S. Efforts to Boost Medical Care for Poor Effective

WEDNESDAY, Feb. 28 (HealthDay News) -- U.S. government efforts to improve care for medically underserved populations have met with some success, an ambitious new study finds.

The analysis of 44 community health centers found gains in disease prevention, screening and treatment for patients with diabetes and asthma but not for patients with hypertension.

"We were looking for evidence of effectiveness of quality improvement, and this provides evidence that these types of techniques can certainly yield at least moderate improvements for these important chronic medical conditions," said study author Dr. Bruce Landon, an associate professor of health-care policy and medicine at Harvard Medical School.

The interventions did not result in benefits in clinical outcomes for patients, however, Landon's team reports in the March 1 issue of theNew England Journal of Medicine.

The Health Disparities Collaboratives, sponsored by the government's Health Resources and Services Administration (HRSA), were designed to improve health care in community health centers, which often cater to underserved populations, including racial and ethnic minorities and uninsured patients.

The centers, which provide care for more than 15 million Americans, are intended to reduce disparities in health-care quality.

The program brings together community health centers to learn and disseminate quality-improvement techniques developed by the Institute for Healthcare Improvement.

As each health center tests and implements small-scale interventions, new practices and procedures are adopted.

This study looked at interventions to improve care at community health centers for individuals with diabetes, asthma or hypertension, chronic diseases which, together, affect more than one-quarter of the U.S. adult population.

The researchers tracked outcomes for 9,658 patients at 44 community health centers participating in the Health Disparities Collaboratives and 20 centers not participating in the program, for comparison. Each center served as an internal control for another condition.

Overall, the centers affected by the intervention showed more improvement in prevention, screening and treatment measures than either the external or internal controls for quality of care for patients with asthma and diabetes, but not hypertension.

There was a 21 percent increase in foot examinations for patients with diabetes in centers participating in the program, a 14 percent increase in the use of anti-inflammatory drugs for asthma, and a 16 percent increase in testing for blood glucose.