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Why Collect Data Using a Uniform Framework
Current Practices
Hospitals
Hospitals play a major role in a community's health care delivery system. But their infrastructure for collecting and using race, ethnicity, and language data is underdeveloped, leading to problems of redundancy, inefficiency, and inaccuracy.
- 78% to 82% of hospitals report collecting race data.
- Far fewer collect ethnicity data.
- 66% of hospitals collect primary language data in the patient medical record.
- 38% maintain a database of patients' primary language, which can be tracked over time.
- 56% collect race/ethnicity data in more than one unit.
- Within the same hospital, different units use different categories.
- Over 50% of hospitals report collecting race/ethnicity data by observation.
- 86% provide limited categories.
- 13% provide a "write-in" response, but these text responses are often not used.
- 10% provide granular race/ethnicity categories tailored to their community's demographics.
- 25% report linking race/ethnicity and language data to quality of care measures.
Medical Group Practices
Little is known about the collection of data on race and ethnicity in medical group practices. Medical groups are less likely than hospitals to collect race and ethnicity data (Nerenz, Currier, and Paez 2004).
- 75% of medical groups that responded to one survey did not collect race/ethnicity data because they thought it was unnecessary or that collection was potentially disturbing to patients.
- Medical groups that collected the data did so primarily for internal quality improvement or disease management purposes, and some were closely affiliated with hospitals that collected data on race/ethnicity as part of the inpatient registration process.
- Recognizing this gap is particularly important. We know far less about health care disparities in the outpatient setting as compared with the inpatient setting.
Community Health Centers (CHCs)
Perhaps because of the tremendous diversity of patients seen at CHCs and their mandate to have their boards of directors represent their communities, CHCs appear to be ahead of the curve in collecting information on patient's race and ethnicity.
- The Bureau of Primary Health Care (BPHC) has demonstrated success in collecting data in this setting. BPHC's Universal Data System stores data from 700 grantees at 3,000 health care sites.
- The BPHC has established specific racial, ethnic, and primary language data collecting and reporting requirements applicable to its network of CHCs.
- The success of these programs provides evidence to other medical groups that this information can be routinely obtained from patients in outpatient practices.
Health Plans
In a study released by America's Health Insurance Plans (AHIP) and the Robert Wood Johnson Foundation, over half (53.5%) of 137 plans that were surveyed collect data that identifies the race or ethnicity of their enrollees.
- 78.2% of Medicaid health plans collect race and ethnicity data.
- 74.3% of Medicare plans collect race and ethnicity data.
- 50.9% of commercial plans collect race and ethnicity data.
Health plans report they collect such data to identify enrollees at risk for certain conditions, to support educational and other communication efforts directed to diverse populations, and to structure quality improvement efforts.
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