Improving Hospital Reporting of Patient Race and Ethnicity--Approaches to Data Auditing.
Improving Hospital Reporting of Patient Race and Ethnicity--Approaches to Data Auditing.
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改进医院对患者种族和民族的报告——数据审计方法。
DOI：
10.1111/1475-6773.12324
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发表时间：
2015
影响因子：
3.4
通讯作者：
Gomez,ScarlettLin
中科院分区：
文献类型：
--
作者：
Zingmond,DavidS;Parikh,Punam;Louie,Rachel;Lichtensztajn,DaphneY;Ponce,Ninez;Hasnain-Wynia,Romana;Gomez,ScarlettLin
目的探讨新的指标，以改善报告的病人种族和种族（R/E）的hospitals.Data来源加州患者出院数据库（PDD）和出生登记，2008-2009年，医疗保健和成本利用项目的国家住院病人数据库，2008-2011年，癌症登记2000-2008年，和2010年美国人口普查摘要文件2.研究设计我们在加州的一个癌症队列中检查了医院报告的R/E与分娩母亲自我报告之间的一致性。创建了RSD来测量医院报告的R/E分布和使用每个患者居住地邮政编码内的R/E分布的R/E估计值之间的均方根差（RMSD）。RMSD比较相应的“金标准”设施水平的措施内产妇队列加州和六个比较state.Data CollectionMaternal出生住院（链接到国家出生登记）和癌症队列记录链接到之前和之后的住院。医院出院联系到相应的人口普查邮政编码制表区使用patient zip codes.Principal FindingsOverall协议之间的PDD和黄金标准的孕产妇队列为86%的合并R/E措施和71%的种族。RMSD指标与R/E的汇总水平黄金标准指标适度相关（r= 0.44）。RMSD指标显示，各州之间的数据一致性和完整性普遍改善。“其他”和“未知”类别不一致的应用范围内住院databases.ConclusionsComparison报告R/E和R/E估计使用邮政编码水平的数据可能是一个合理的第一种方法来评估和跟踪医院R/E报告。进一步的工作应侧重于使用更细粒度的地理编码数据进行估计和跟踪数据，以改善医院收集的R/E数据。
ObjectiveTo investigate new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals.Data SourcesCalifornia 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 DesignWe 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 CollectionMaternal 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 FindingsOverall 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.ConclusionsComparison 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.