OBJECTIVE To evaluate the Ohio Diabetes Quality Improvement Project (QIP) equity aim to reduce the percentage of Non-Hispanic Black (NHB) and Hispanic patients with A1C >9% by ≥20% over 2 years. RESEARCH DESIGN AND METHODS The Ohio Department of Medicaid, Ohio Colleges of Medicine Government Resource Center, Ohio Medicaid managed care plans, and seven medical schools in Ohio formed the Diabetes QIP collaborative using the collective impact model to improve diabetes outcomes and equity in 20 practices across 11 health systems. The quality improvement (QI) strategies included data audit and feedback, peer-to-peer learning, QI coaching/practice facilitation, and subject matter expert consultation through coaching calls, monthly webinars, and annual virtual learning sessions. Electronic health record data were collected for preintervention (2019–2020) and intervention (2020–2022) periods. Assessments of improvements in A1C were based on prevalence of A1C >9% from preintervention, year 1, and year 2 with stratification by race and ethnicity. RESULTS The Diabetes QIP included 7,689 (54% female) sociodemographically diverse patients, self-identifying as non-Hispanic White (NHW) (42%), NHB (43%), Hispanic (8%), non-Hispanic Asian (4%), or other (3%). In year 2 compared with baseline, there were decreases in the proportion of patients with A1C >9% among NHW, NHB, and Hispanic patients (NHW from 19% to 12% [37% reduction], NHB 23% to 18% [22% reduction], and Hispanic 29% to 23% [20% reduction]). CONCLUSIONS The Ohio Diabetes QIP, focused on multisector collaborative approaches, reduced the percentage of patients with A1C >9% by ≥20% among NHW, NHB, and Hispanic populations. Given the persistence of disparities, further equity-focused refinements are warranted to address disparities in diabetes control.

中文翻译：

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对 Medicaid 资助的全州糖尿病质量改进项目合作进行以公平为重点的评估


目的 评估俄亥俄州糖尿病质量改进项目 （QIP） 公平性，目的是在 2 年内将非西班牙裔黑人 （NHB） 和西班牙裔 A1C >9% 患者的百分比降低 ≥20%。研究设计和方法 俄亥俄州医疗补助部、俄亥俄医学院政府资源中心、俄亥俄州医疗补助管理式医疗计划和俄亥俄州的七所医学院组成了糖尿病 QIP 合作组织，使用集体影响模型来改善糖尿病结果和公平性 11 个卫生系统的 20 种实践。质量改进 （QI） 策略包括数据审计和反馈、点对点学习、QI 辅导/实践促进，以及通过辅导电话、每月网络研讨会和年度虚拟学习会议进行的主题专家咨询。收集了干预前 （2019-2020） 和干预 （2020-2022） 期间的电子健康记录数据。A1C 改善的评估基于干预前、第 1 年和第 2 年的 A1C >9% 患病率，并按种族和民族分层。结果 糖尿病 QIP 包括 7,689 名（54% 女性）社会人口统计学多元化的患者，自我认同为非西班牙裔白人 （NHW） （42%）、NHB （43%）、西班牙裔 （8%）、非西班牙裔亚洲人 （4%） 或其他 （3%）。与基线相比，第 2 年，NHW、NHB 和西班牙裔患者中 A1C >9% 患者的比例有所下降 （NHW 从 19% 降至 12% [减少 37%]，NHB 从 23% 降至 18% [减少 22%]，西班牙裔患者从 29% 降至 23% [减少 20%）]。结论俄亥俄州糖尿病 QIP 专注于多部门合作方法，在 NHW、NHB 和西班牙裔人群中，A1C >9% 患者的百分比降低了 ≥20%。 鉴于差异的持续存在，有必要进一步进行以公平为重点的改进，以解决糖尿病控制方面的差异。