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Reducing Disparities through Research and Translation. AHRQ 2011 Sue Swenson, DAS USED/OSERS sue.swenson@ed.gov. People with Disabilities. About 19% of Americans have functional limitations About 12% of Americans have a “ severe ” disability
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Reducing Disparities through Research and Translation AHRQ 2011 Sue Swenson, DAS USED/OSERS sue.swenson@ed.gov
People with Disabilities About 19% of Americans have functional limitations About 12% of Americans have a “severe” disability Source: DREDF, Improving Health and Access to Health Care for People with Disabilities, May 2009
People Who Report Fair or Poor Health Asians - 8% Blacks - 18% American Indian/Alaska Native - 22% Hispanic - 23% People with Disability - 40% Source: “Health Disparities Chart Book on Disability and Racial and Ethnic Status in the United States,” IOD/UNH, 2011
Questions of value • Is disability stigmatized? • “This is a good enough outcome.” • “Disability is not compatible with health.” • “Those people need to see someone who specializes in their disability.” • “People would rather die than live with disability.” • “It costs too much to include people with disabilities in my practice.” • “I have time limits.”
Doctor = Teacher • The unspoken lesson: • If you can’t get to the doctor’s office, • If the office doesn’t take your insurance, • If you can’t get into the doctor’s office, • If you can’t get onto the examining table, • If you can’t access testing or treatment equipment, • If you can’t understand diagnostic questions, risks and instructions, • If you don’t have the community support you need to carry out recommendations,
Doctor = Teacher • The unspoken lesson: • You don’t belong here. • Your health does not matter.
The Marketing Discipline • Carve nature at its joints • Understand segments • Shared want, need, and way to pay • Shared information channels
Segments • Racial minorities • Ethnic minorities • Multi-ethnic identity • Density/ urbanicity • Income/poverty • Lifestyle/values • Disability • Gender • Age
Proprietary Market Research One example: Nielsen Claritas PRIZM There are 66 PRIZM segments
Knowledge Translation: • Cross-cutting effort, like technology • F/T staff in a small office • pimjai.sudsawad@ed.gov • Invitational training
NIDRR-funded Center on Knowledge Translation and Technology Transfer: KT4TT SUNY/Buffalo http://www.kt4tt.buffalo.edu
Managing the learning curve • Competition as a source of innovation • Market share = learning curve • Segmentation is a marketing strategy – not a goal. • Can market penetration result from grant funding? • New funding mechanisms? • Part for-profit, part non-profit • Stanford Social Innovation Review • Is there a cross-government effort to look at this? • Could ICDR look at this?
Ethics, Systems and Quality • Measure inputs, outputs, results, outcomes and impacts • For those you serve and those you should serve