--- title: "Measure health equity in primary care. | Sutter Health" description: "We designed and implemented an index, calculated as the ratio of observed-to-expected encounters, to quantify health inequalities in healthcare systems." url: "https://www.sutterhealth.org/research/publications/measure-health-equity-in-primary-care-1055312457" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Measure health equity in primary care. # Measuring health equity for ambulatory care sensitive conditions in a large integrated health care system: the development of an index. Pressman A, Lockhart S, Petersen J, Robinson S, Moreno M, & Azar KMJ. _Health Equity. 3(1):92-98. doi: 10.1089/heq.2018.0092. eCollection 2019._ 2019-04-03 ## Abstract Disparities in outcomes for preventive and primary health care services often result when vulnerable patients rely on episodic encounters for emergency services that do not meet their long-term health needs. Understanding health outcomes in socially or economically disadvantaged subgroups is crucial to improving community health, and it requires innovative analytics and dynamic application of clinical and population data. While it is common practice to use proxy indicators, such as quality of life and mortality, when discussing health equity, these have shown limited utility and are rarely applied at a population-level within a health system. Therefore, we designed and implemented an index, calculated as the ratio of observed-to-expected encounters, to identify and quantify health inequalities in health care systems. Providing equitable care, as measured by health outcomes, is analogous to precision medicine applied to social determinants. For health systems, the use of this index will facilitate the development of specially-tailored interventions to address inequity and provides a tool to measure the impact of such programs. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/30963142) ![Kristen M J Azar, RN, MSN, MPH](https://dyn.mktgcdn.com/p/rFmyR1kiX8JzE5-XNwup0gVC1GRaVTlH7oSDlG0Tr5A/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Kristen M J Azar, RN, MSN, MPH Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/kristen-m-j-azar-rn-msn-mph-1049680985) ## Research topics - [Health Disparities](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Disparities%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [An evaluation of two interventions to enhance patient-physician communication using the observer OPTION5 measure of shared decision making.](https://www.sutterhealth.org/research/publications/eval-2-interv-enhance-pt-md-comm-option5-measure-1055312393) Dillon EC, Stults CD, Wilson C, Chuang J, Meehan A, Li M, Elwyn G, Frosch DL, Yu E, Tai-Seale M. Patient Educ Couns. pii: S0738-3991(17)30254-9. doi: 10.1016/j.pec.2017.04.020. \[Epub ahead of print\] 2017 May 01 - Publication ### [R-E-S-P-E-C-T--what it means to patients.](https://www.sutterhealth.org/research/publications/r-e-s-p-e-c-t-what-it-means-to-patients-1055312647) Frosch DL, Tai-Seale M. J Gen Intern Med. 29(3):427-8. doi: 10.1007/s11606-013-2710-z. 2014 Mar 01 - Publication ### [Community health worker training and certification programs in the United States: findings from a national survey.](https://www.sutterhealth.org/research/publications/comm-health-wker-training-certif-progrms-us-1055312544) Kash BA, May ML, Tai-Seale M. Health Policy. 80(1):32-42. Epub 2006 Mar 29. 2007 Jan 01 - Publication ### [Factors associated with accuracy of self-assessment compared with tested non-English language proficiency among primary care providers.](https://www.sutterhealth.org/research/publications/mds-non-english-lang-proficiency-self-vs-tested-assessmt-1055312513) Diamond L, Toro Bejarano M, Chung S, Ferguson W, Gonzalez J, Genoff Garzon M, Mujawar I, Gany F. Med Care. doi: 10.1097/MLR.0000000000001105. \[Epub ahead of print\] 2019 Mar 05 - Publication ### [The 1994-1995 National Health Interview Survey on Disability (NHIS-D): a bibliography of 20 years of research.](https://www.sutterhealth.org/research/publications/national-health-interview-survey-on-disability-1055312487) Ward BW, Ridolfo H, Creamer L, Gray C. Rev Disabil Stud. 11(2):1-22. 2015 Apr 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/measure-health-equity-in-primary-care-1055312457#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Measure health equity in primary care."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/measure-health-equity-in-primary-care-1055312457#medicalscholarlyarticle","name":"Measuring health equity for ambulatory care sensitive conditions in a large integrated health care system: the development of an index.","headline":"Measure health equity in primary care.","abstract":"Disparities in outcomes for preventive and primary health care services often result when vulnerable patients rely on episodic encounters for emergency services that do not meet their long-term health needs. 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