Dataset Information

Improving Hospital Reporting of Patient Race and Ethnicity--Approaches to Data Auditing.

ABSTRACT:

Objective

To investigate new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals.

Data sources

California Patient Discharge Database (PDD) and birth registry, 2008-2009, Healthcare and Cost Utilization Project's State Inpatient Database, 2008-2011, cancer registry 2000-2008, and 2010 US Census Summary File 2.

Study design

We examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort in California. Metrics were created to measure root mean squared differences (RMSD) by hospital between reported R/E distribution and R/E estimates using R/E distribution within each patient's zip code of residence. RMSD comparisons were made to corresponding "gold standard" facility-level measures within the maternal cohort for California and six comparison states.

Data collection

Maternal birth hospitalization (linked to the state birth registry) and cancer cohort records linked to preceding and subsequent hospitalizations. Hospital discharges were linked to the corresponding Census zip code tabulation area using patient zip code.

Principal findings

Overall agreement between the PDD and the gold standard for the maternal cohort was 86 percent for the combined R/E measure and 71 percent for race alone. The RMSD measure is modestly correlated with the summary level gold standard measure for R/E (r = 0.44). The RMSD metric revealed general improvement in data agreement and completeness across states. "Other" and "unknown" categories were inconsistently applied within inpatient databases.

Conclusions

Comparison between reported R/E and R/E estimates using zip code level data may be a reasonable first approach to evaluate and track hospital R/E reporting. Further work should focus on using more granular geocoded data for estimates and tracking data to improve hospital collection of R/E data.

SUBMITTER: Zingmond DS

PROVIDER: S-EPMC4545337 | biostudies-literature | 2015 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Improving Hospital Reporting of Patient Race and Ethnicity--Approaches to Data Auditing.

Zingmond David S DS Parikh Punam P Louie Rachel R Lichtensztajn Daphne Y DY Ponce Ninez N Hasnain-Wynia Romana R Gomez Scarlett Lin SL

Health services research 20150615

<h4>Objective</h4>To investigate new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals.<h4>Data sources</h4>California Patient Discharge Database (PDD) and birth registry, 2008-2009, Healthcare and Cost Utilization Project's State Inpatient Database, 2008-2011, cancer registry 2000-2008, and 2010 US Census Summary File 2.<h4>Study design</h4>We examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort i ...[more]

PMID: 26077950

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Project description:BackgroundSystemic progress in improving trial representation is uncertain, and previous analyses of minority trial participation have been limited to small cohorts with limited exploration of driving factors.MethodsWe analyzed detailed trial records from all US clinical trials registered in ClinicalTrials.gov from March 2000 to March 2020. Minority enrollment was compared to 2010 US Census demographic estimates using Wilcoxon test. We utilized logistic regression and generalized linear regression with a logit link to assess the association of possible drivers (including trials' funding source, size, phase, and design) with trials' disclosure of and amount of minority enrollment respectively.FindingsAmong 20,692 US-based trials with reported results (representing ~4·76 million enrollees), only 43% (8,871/20,692) reported any race/ethnicity data. The majority of enrollees were White (median 79·7%; interquartile range [IQR] 61·9-90·0%), followed by Black (10·0%; IQR 2·5-23·5%), Hispanic/Latino (6·0%; IQR 0·43-15·4%), Asian (1·0%; IQR 0·0-4·1%), and American Indian (0·0%; IQR 0·0-0·2%). Median combined enrollment of minority race/ethnicity groups (Black, Hispanic/Latino, Asian, American Indian, Other/Multi) was below census estimates (27·6%) (p<0·001) however increased at an annual rate of 1·7%. Industry and Academic funding were negatively associated with race/ethnicity reporting (Industry adjusted odds ratio [aOR]: 0·42, 95% confidence interval [CI]: 0·38 to 0·46, p<0.0001; Academic aOR: 0·45, CI: 0·41 to 0·50, p<0.0001). Industry also had a negative association with the proportion of minority ethnicity enrollees (aOR: 0·69, CI: 0·60 to 0·79) compared to US Government-funded trials.InterpretationOver the past two decades, the majority of US trials in ClinicalTrials.gov do not report race/ethnicity enrollment data, and minorities are underrepresented in trials with modest improvement over time.FundingStanford Medical Scholars Research Funding, the National Heart, Lung, and Blood Institute, NIH (1K01HL144607) and the American Heart Association/Robert Wood Johnson Medical Faculty Development Program.

Project description:During 1994-1997, approximately 70% and 60% of the cases of conditions reported to the National Notifiable Diseases Surveillance System included persons of known race and ethnicity, respectively. A major goal of the Healthy People 2020 initiative is to eliminate health disparities.To describe trends in the completeness of race and ethnicity in case reports of the National Notifiable Diseases Surveillance System during 2006-2010.The National Notifiable Diseases Surveillance System is a public health surveillance system that aggregates case reports of infectious diseases and conditions that are designated nationally notifiable and are collected by US states and territories. The Centers for Disease Control and Prevention (Atlanta, Georgia) maintains this surveillance system in collaboration with the Council of State and Territorial Epidemiologists. We used Cochran-Armitage Trend Test (SAS, version 9.2) to test the hypothesis that the percentage of case reports with the completeness of race and ethnicity data increased or decreased linearly during 2006-2010.Completeness of race and ethnicity variables.The 32 conditions reviewed included 1 030 804 case records. Seventy percent of records included a known value for race, and 49% of records included ethnicity during 2006-2010. During 2006-2010, race was known in 70% or more of records in 24 of 32 conditions and in 23 of 51 jurisdictions. During 2006-2010, the systemwide reporting of race remained at the same level of completeness (70%) but the reporting of ethnicity increased slightly from 48% in 2006 to 53% in 2010. In comparison with race, the proportions of records coded to ethnicity were less among all conditions.Significant change has occurred in the completeness of reporting of ethnicity but not race during 2006-2010. However, the reporting of ethnicity still lags substantially behind the reporting of race. Jurisdictions that identify conditions with lower rates of completeness of race and ethnicity can assess the net benefits of efforts to improve the completeness of race and ethnicity data.

Dataset Information

Improving Hospital Reporting of Patient Race and Ethnicity--Approaches to Data Auditing.

Objective

Data sources

Study design

Data collection

Principal findings

Conclusions

Publications

Improving Hospital Reporting of Patient Race and Ethnicity--Approaches to Data Auditing.

Similar Datasets

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