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Racial disparities persist at VA patient-centered medical homes

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Racial and ethnic disparities have persisted at Veterans Administration patient-centered medical homes, says a Health Affairs article. The authors conclude:

“Improved clinical outcomes and equity are dual aims of quality improvement overall, particularly in the context of patient-centered medical homes. Overall, improvements in clinical outcomes had not been achieved for whites or most racial/ethnic groups four years into VA’s systemwide roll-out of the PACT {Patient-Aligned Care Team} initiative. Though we found that greater PACT implementation was associated with higher percentages of veterans who achieved hypertension or diabetes control, most racial/ethnic disparities in achieving control also persisted. The potential PACT effects on racial/ethnic outcomes and disparities were likely offset by factors internal and external to the VA, such as increased patient demand, variable PACT implementation (especially in facilities with large proportions of minority veterans), and social determinants of health among VA users.

“Within the context of PACT implementation, the finding of persistent racial/ethnic disparities broadly suggests that additional strategies are needed to reduce disparities. Health care systems seeking to promote health equity should incorporate tailored strategies aimed at reducing disparities into health care innovations such as patient-centered medical homes and should monitor outcomes and experiences of their patients by race/ethnicity.”

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