Monitoring Disparities in Chronic Conditions Study: The MDCC Study
Disparities in health outcomes, health determinants, access, and quality of health care are ongoing policy priorities in the United States. Studies have shown disparities across multiple domains for a wide range of chronic conditions, including cardiovascular diseases, respiratory diseases, diabetes, cancers, psychiatric disorders, and musculoskeletal conditions. Behavioral risk factors, such as tobacco smoking, physical inactivity, and poor diet, are likely to play a big role in health disparities. However, health disparities are also reflected in differing levels of access to health care and the quality of medical care.
- Dartmouth Institute for Health Policy & Clinical Practice
- Harvard School of Public Health
- Public Health – Seattle & King County
1. Design data systems
The MDCC Study team is designing a novel, cost-effective, multisource data collection system for producing high-quality data in the four domains. In order to track race/ethnicity disparities in chronic diseases and the effectiveness of health policy in reducing these disparities, national data alone are not sufficient. In this project, our data system integrates data from emergency medical services (EMS), hospital discharge databases, outpatient care databases, Medicare databases, selective chart review and extraction, and pharmacy records.
2. Develop surveys
To supplement database and record information, the MDCC Study team has developed surveys that can be administered in one of four formats: a computer-adapted telephone interview (CATI) survey; a computer-assisted personal interview (CAPI); a Web-based survey; and a paper-based survey. These various modalities allow study participants to choose the method that works best for them and enhances the completeness and quality of the survey data. The MDCC surveys ask questions about health and well-being, demographic information (i.e., race/ethnicity, employment, income), functional health, risk factors (i.e., physical activity, weight, tobacco/alcohol use, diet), self-reported symptoms, prior diagnosis of specific chronic conditions (i.e., diabetes, asthma), and health service utilization.
3. Review medical records and conduct physical examinations
4. Link data sources
The value of each component of the surveillance data (surveys, service provider data, and physical examination data) will be enhanced through record linkage. Record linkage across these data systems will allow us to trace sequences of events for individuals, from socioeconomic contexts and risk factors to interactions with the health system and health outcomes.
5. Pilot test and disseminate information
- Streamline operational details (i.e., working with local health authorities and community leaders to ensure high response rates).
- Refine instruments (i.e., insure comparability across cultures and languages).
- Establish protocols for linkage and demonstrate operational feasibility.
- Enable researchers to better understand health issues among multicultural populations with varying geography and income.
- Expand the project to other race/ethnic groups and counties throughout the United States.
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This project is supported by award number RC2HL101759 from the National Heart, Lung, and Blood Institute, which is part of the US National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health.
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The goal of this project is to design a data collection system that will track chronic diseases and their risk factors in US communities through multiple sources.
The National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health