2016 Medical Care Student Award Papers
We offer below brief thoughts on each presentation in the hope of enticing you to read each in detail.
“State variation in quality outcomes and disparities in outcomes in community health centers.”1 In the Cole and colleagues research study, readers will step into the world of quality assessment for a challenging population—those who are eligible for services in community health centers (CHC) based on socioeconomic markers of need, for example, low income and lack of health insurance. The study encompasses a large pool of national self-assessed quality CHC data across 5 years and measures the extent to which quality care is achieved for common chronic conditions, for example, hypertension and diabetes. The Centers for Disease Control and Prevention (CDC) has developed quality benchmarks for these conditions, for example, whether the health care facility “achieved 140/90 blood pressure in 90% of cases.” The study examines the measures within-states for the total state population and for racial/ethnic disparities for white: African American and white: Hispanic patients. Also, between-state measures are presented to identify the most achieving and least achieving states. The authors provide these data, particularly to state policy agencies, so that improvements can be targeted for low achieving states, whereas high achieving states can be studied further to elaborate the factors that may be responsible for their success.
Interestingly, the disparities in these quality measures rely on CDC standards which assert that the quality standard is achievable. Such goals are valuable but could be greatly strengthened by patient measures of clinical change over time. Meanwhile, readers may opt to advocate for the inclusion of patient level data, for example, on severity, prior history and clinical management, such as, laboratory values and medication regimens, as well as patient satisfaction. For the present, policy specialists can take up the challenge Cole and colleagues provide so convincingly.
“Trafficking and trauma: insight and advice for the health care system from sex-trafficked women incarcerated on Rikers Island.”2 For New Yorkers, the words “Rikers Island” sends a chill reminding us of the ongoing flow of concerns about prisoner safety, uncontrolled prisoner violence, uncontrolled guard violence and an endless effort to stop administrator corruption. Now, with the strength and will of a research collaboration of a graduate student and Rikers Island staff, we have detailed survey information on improving the health care participation of sex-trafficked women from the perspective of sex-trafficked women expressed in their own words. Quite a feat, no doubt! Ravi and colleagues provide a roadmap of themes including the women’s experience with violence, substance use, and suggestions to improve their participation in the health care system.