Standardized Data Collection Practices and the Racial/Ethnic Distribution of Hospitalized Patients

Bibliographic Data

ID9102717
AuthorsRosette J Chakkalakal (0000-0001-9318-1856, Robert Wood Johnson Foundation, corresponding author), Jeremy Green (0000-0003-2806-1924, Saint Louis University), Jeremy C Green, Harlan M Krumholz (0000-0003-2046-127X, Yale New Haven Hospital, corresponding author), Brahmajee K Nallamothu (0000-0003-4331-6649, University of Michigan)
Year2015
Volume53
Issue8
Pages666-672
Publication date2015-08-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000392
PMID26147864
PMCIDPMC4503513
OpenAlexW2418858450
LanguageEN
Citations received3
References cited19

BACKGROUND: Although frequently used to track health care disparities, patient race/ethnicity data collected by hospitals can be unreliable, particularly for smaller minority groups. We sought to determine whether the racial/ethnic distribution of hospitalized patients shifted after implementation of a statewide initiative to standardize data collection practices. METHODS: We conducted a difference-in-differences analysis of the State Inpatient Databases to estimate changes in the proportion of patients identified as non-Hispanic white, non-Hispanic black, Hispanic, Asian/Pacific Islander, and "other," before (2005-2006) and after (2008-2009) standardized practices were implemented in New Jersey relative to New York, a state with similar demographics but no changes to data collection. RESULTS: Among 12,552,702 hospital discharges, modest relative changes were noted in the proportion of patients identified as non-Hispanic white [+1.1%; 95% confidence interval (CI): +0.9 to +1.2] and non-Hispanic black (+1.6%; 95% CI: +1.1 to +2.1) in New Jersey that were attributed to its use of standardized data collection practices as compared with New York. Larger relative changes were noted in the proportion of patients identified as Hispanic (-7.1%; 95% CI: -7.8 to -6.4), Asian/Pacific Islander (+26.5%; 95% CI: +25.1 to +27.9), and "other" (-24.6%; 95% CI: -26.4 to -22.8). This pattern was largely consistent in analyses stratified by sex, age, and Major Diagnostic Category. CONCLUSIONS: Measurement of health care disparities fundamentally depends on the racial/ethnic categorization of individuals. By redistributing substantial proportions of patients across smaller minority groups, standardized data collection could lead to shifts in estimates of health care disparities for these rapidly growing populations

Confidence interval · Data collection · Demographics · Environmental health · Ethnic group · Pacific islanders · Population · Demography · Global Cancer Incidence and Screening · Internal Medicine · Medicine · Primary Care and Health Outcomes · Racial and Ethnic Identity Research · Gerontology

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