Health Disparities and the Quality of Ambulatory Care

The seminal Institute of Medicine report, Crossing the Quality Chasm, identified several attributes of the health care system needed for the 21st century. These include equity; providing care that does not vary in quality because of personal characteristics such as sex, ethnic background, geographic location, and socioeconomic status; and effectiveness. In order to achieve these aims, the Institute of Medicine concluded, health system redesign must address organizational challenges such as the coordination of care across patient conditions, services, and settings over time and the effective use of clinical teams. These are not simply ideals; health system redesign is required to achieve optimal health outcomes and meet our national objective of eliminating disparities in health.