Racial/ethnic, socioeconomic and regional disparities in healthcare are pervasive and well-established. The theme of this talk is the interplay of descriptive, predictive, normative and causal considerations in analysis and action around disparities. I
will present an accepted definition of disparities and discuss its connection to values about equality of opportunity, and its implementation in descriptive analyses. I next consider the role of care-providing “units” in disparities, distinguishing the
interpretation of within- and between-unit effects. Discussion of casemix adjustment leads to a focus on the current controversy over socioeconomic adjustment of hospital readmission measures. Finally I will discuss the relationship of notions of causality
engaged in the preceding topics to the “potential outcomes” school of causal inference.
Alan M. Zaslavsky, PhD, is a professor of health care policy (statistics) in the Department of Health Care Policy at Harvard Medical School. His methodological research interests include surveys, census methodology, microsimulation models, missing data,
hierarchical modeling, small-area estimation, and applied Bayesian methodology. His health services research focuses primarily on developing methodology for quality measurement of health plans and providers and understanding the implications of these quality
An important part of his work concerns the development, implementation, and analysis of the Consumer Assessments of Healthcare Providers and Systems (CAHPS) survey, a comprehensive program involving development of survey instruments for eliciting enrollee reports
and ratings of their health plans, hospitals, provider groups and similar units and the care they receive through them, a standard analysis package, and methods for reporting results to potential enrollees and purchasers. As a statistical leader in the implementation
of the CAHPS survey for the Medicare population, he has studied individual characteristics affecting responses to the survey, the main dimensions of quality measured by the survey, the contributions of the health plan and geographical location to CAHPS-measured
quality, comparisons of traditional Medicare to Medicare Advantage and Medicare Accountable Care Organizations, and risk selection among health plans.
He collaborates on analyses for the World Mental Health Surveys and for the Army STARRS study of suicides in the armed forces. Dr. Zaslavky's interests also include methodology for measuring racial and ethnic disparities in care and determing their causes,
quality measurement for pediatric hospital care, and national opinion research on health policy issues.
Dr. Zaslavsky earned his BA from Harvard College, his master’s degree in statistics and computer science from Northeastern University, and his PhD in applied mathematics, with a specialty in statistics, from the Massachusetts Institute of Technology. He is
a fellow of the American Statistical Association, an elected member of the International Statistical Institute, and a national associate of the National Academy of Sciences. He has served on numerous panels on decennial census methodology, small-area estimation,
measurement of race for health and health services research, and healthcare quality reporting for the Institute of Medicine and the Committee on National Statistics (CNSTAT) of the National Academy of Sciences, on which he has also served.
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Light refreshments will be served following the lecture in Rm L107.