Measuring disparities in health care

Disparities in the quality of health care and in the occurrence of medical errors are hot issues in contemporary medicine and health policy. This debate stems mainly from reports on disparities in the quality of health care by the US Institute of Medicine and recommendations for health systems to reduce “medical errors.”1 2 Given evidence of stratification in healthcare quality by racial, ethnic, geographic, gender, and socioeconomic factors, we still have not settled on the right methods for quantifying inequalities. Policy responses will depend on appropriate methods.

Asch and colleagues3 recently studied the variation in rates at which people in different sociodemographic subgroups in the United States received necessary health care. In each subgroup they found a large gap between the observed and desired …