Equity has been considered a pillar of quality since the first definitions of health care quality emerged. For our part, 'population health and equity’ features in the New Zealand Triple Aim for health care improvement.
Until recently, however, few quality improvement agencies – both here and overseas – have shown commitment to achieving health equity.
This is now changing, with growing interest across several jurisdictions in how the health quality movement can play its part in reducing health inequities.
‘Improving health equity’ is one of the Commission’s four new strategic priorities. We are designing and implementing actions across our work programmes that will help us achieve it.
This think piece (link below) records our first steps. We were interested in whether equitable actions could fit in a quality improvement context: are the approaches compatible, or are there tensions between them?
We spoke with key informants and reviewed the literature, to consider how pro-equity actions can slot into established quality improvement methodologies. The bottom line is that quality improvement and pro-equity approaches can co-exist, but we need to retain an element of adaptability that allows our interventions to flex to suit population groups. In other words, treating everybody the same will not improve health equity.
In our work, we refer to health inequities as avoidable and unfair differences in health outcomes. Health equity means people receive the care they require – as distinct from health equality (where everyone receives the same).