Use of geocoding and surname analysis to estimate race and ethnicity
Use of geocoding and surname analysis to estimate race and ethnicity
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DOI：
10.1111/j.1475-6773.2006.00551.x
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发表时间：
2006-08-01
影响因子：
3.4
通讯作者：
Fremont, Allen M.
中科院分区：
文献类型：
--
作者：
Fiscella, Kevin;Fremont, Allen M.
客观的。回顾两种间接方法，即地理编码和姓氏分析，用于估计种族/族裔，作为健康计划评估护理差异的一种手段。研究设计。审查有关使用地理编码和姓氏分析的已发表文章和未发表数据。主要发现。很少有已发表的研究评估了使用地理编码来估计患者群体的种族和民族特征或评估医疗保健方面的差异。四分之三的研究显示了对黑人比例的相似估计，一项研究显示了几乎相同的种族差异估计，无论是否使用间接或更直接的测量（例如死亡证明或 CMS 数据）。然而，准确性取决于所评估的人口和地区的种族隔离水平，并且地理编码对于识别西班牙裔和亚洲人/太平洋岛民来说并不可靠。同样，一些研究表明，姓氏分析可以合理估计参与者是西班牙裔还是亚洲/太平洋岛民，并可以识别护理方面的差异。然而，准确性取决于评估区域中亚洲人或西班牙裔的集中程度。对于女性以及由于异族通婚、改名和收养而文化程度更高、社会经济地位更高的人来说，它的准确度较低。姓氏分析对于识别非裔美国人来说并不准确。最近未发表的分析表明，计划可以成功地使用地理编码/姓氏组合分析方法来确定大多数地区的护理差异。基于贝叶斯方法的改进可能会使地理编码/姓氏分析适合在目前精度较差的地区使用，但需要验证这些初步结果。结论。当缺乏主要种族和民族群体的直接数据时，地理编码和姓氏分析显示出估计参与者的种族/民族健康计划构成的希望。这些数据可用于评估护理方面的差异，等待自我报告的种族/民族数据的可用性。
Objective. To review two indirect methods, geocoding and surname analysis, for estimating race/ethnicity as a means for health plans to assess disparities in care.Study Design. Review of published articles and unpublished data on the use of geocoding and surname analyses.Principal Findings. Few published studies have evaluated use of geocoding to estimate racial and ethnic characteristics of a patient population or to assess disparities in health care. Three of four studies showed similar estimates of the proportion of blacks and one showed nearly identical estimates of racial disparities, regardless of whether indirect or more direct measures ( e. g., death certificate or CMS data) were used. However, accuracy depended on racial segregation levels in the population and region assessed and geocoding was unreliable for identifying Hispanics and Asians/Pacific Islanders. Similarly, several studies suggest surname analyses produces reasonable estimates of whether an enrollee is Hispanic or Asian/Pacific Islander and can identify disparities in care. However, accuracy depends on the concentrations of Asians or Hispanics in areas assessed. It is less accurate for women and more acculturated and higher SES persons due intermarriage, name changes, and adoption. Surname analysis is not accurate for identifying African Americans. Recent unpublished analyses suggest plans can successfully use a combined geocoding/surname analyses approach to identify disparities in care in most regions. Refinements based on Bayesian methods may make geocoding/surname analyses appropriate for use in areas where the accuracy is currently poor, but validation of these preliminary results is needed.Conclusions. Geocoding and surname analysis show promise for estimating racial/ethnic health plan composition of enrollees when direct data on major racial and ethnic groups are lacking. These data can be used to assess disparities in care, pending availability of self-reported race/ethnicity data.