Evaluating the Elimination of Disparities: Issues and Approaches to Health Status and Outcomes Assessment

Abstract

Most HRSA evaluation activities are funded through the 1-percent evaluation set aside authority, and these evaluations receive the most scrutiny within the agency. Agency, bureau, and program strategic plans, as well as Department of Health and Human Services (DHHS) priorities, provide the framework for planning and establishing funding priorities for evaluation studies. Studies that measure the extent to which HRSA is eliminating disparities, through measuring health outcomes and status, are typically viewed as crucial. Nonetheless, as integral as these studies are, several challenges preclude easy assessment of health outcomes. Several approaches used by the Bureau of Primary Health Care and the HIV/AIDS Bureau to address these challenges are presented. These approaches include developing uniform data sets that cross program boundaries; using existing data sources that allow inferences to be drawn about the impact that HRSA programs are having on health outcomes; conducting national surveys of populations served by HRSA programs; and conducting targeted evaluation studies at a small number of grantee locations to draw inferences from these studies about more general program impacts.