Improving Reporting of Race, Ethnicity, and Language in California

描述(申请人提供)：加州是一个庞大和多样化的人口超过3700万人的家园，其中包括美国最大的拉丁裔、美洲原住民、太平洋岛民和亚洲人口。这些人中有很大一部分人在语言上是孤立的。有充分证据表明，在种族/族裔少数群体和有语言障碍的人中，护理方面的差距要大得多。尽管加州要求报告种族、民族和语言，但缺乏关于收集什么、如何以及何时收集这些数据的具体指导方针，导致报告不一致，这是更好地了解健康差距的严重障碍。加州卫生规划和发展办公室(OSHPD)是一个州机构，负责全州患者级别的医院住院患者、急诊科和门诊手术数据的常规收集。患者出院数据库每年有超过400万的出院数据，是AHRQ全国住院患者样本中最大的单一成分数据库，也是AHRQ医疗成本和利用项目提供的最大住院患者数据库。每年向OSHPD报告的急诊科就诊次数超过1000万次，门诊手术次数为240万次。针对RFA-HS-10-010，“ARRA OS：2009年有限竞争恢复法：增强的用于分析和跟踪比较有效性影响的州数据：改进的临床内容和种族-种族数据(R01)”，一个由加州大学调查人员领导的盟军研究小组与加州全州卫生规划和发展办公室的领导合作，提出了一项为期三年的程序性干预措施，以提高目前在OSHPD监管授权范围内的三个数据库中由医院提供的自我报告的种族、民族和主要语言的可靠性、有效性和完整性。拟议项目的目标是：1.在加利福尼亚州和比较州的医院对种族、民族和语言数据的收集、报告和准确性进行基线评估。2.直接提高医院收集的种族、民族、语言信息的准确性和可靠性(直接改进自报数据)。3.使用补充数据和统计方法改进医院报告的种族和族裔指标(间接改进自我报告的数据)。通过AHRQ资助的这个项目，我们希望在加州医院接受护理的患者中，对种族、民族和主要语言的报告做出实质性和可持续的改进。 公共卫生相关性：拟议研究的目的是逐步提高从所有住院患者、急诊科患者或在加州医院接受门诊手术的患者收集的自我报告种族、民族和语言的完整性和准确性。结果可以用来更准确地识别和解决因种族、民族和语言相关问题而产生的潜在健康和医疗保健差距。

DESCRIPTION (provided by applicant): California is home to a large and diverse population of over 37 million individuals, including the largest Latino, Native American, Pacific Islander, and Asian populations in the U.S. A large percentage of these individuals are linguistically isolated. Disparities in care are well documented to be significantly higher among racial/ethnic minorities and among those with language barriers. Although California requires race, ethnicity, and language reporting, a lack of specific guidelines for what, how, and when this data should be collected has contributed to inconsistency in reporting, a significant barrier to better understanding the magnitude of health disparities. California's Office of Statewide Health Planning and Development (OSHPD), a state agency, is responsible for the routine collection of patient-level hospital inpatient, emergency department, and ambulatory surgery data across the state. The Patient Discharge Database has over 4 million discharges annually and is the largest single constituent database contributing to the AHRQ National Inpatient Sample and the largest inpatient database offered by AHRQ Healthcare Cost and Utilization Project. Over ten million emergency department encounters and 2.4 million ambulatory surgeries are reported to OSHPD annually. In response to RFA-HS-10-010, "ARRA OS: Recovery Act 2009 Limited Competition: Enhanced State Data for Analysis and Tracking of Comparative Effectiveness Impact: Improved Clinical Content and Race-Ethnicity Data (R01)," a team of allied researchers led by investigators from the University of California in collaboration with the leadership of the California Office of Statewide Health Planning and Development, propose a three- year programmatic intervention to improve the reliability, validity, and completeness of self-reported race, ethnicity, and primary language provided by hospitals in the three databases that are currently within OSHPD's regulatory mandate. The aims of the proposed project are to: 1. Perform a baseline assessment of race, ethnicity, and language data collection, reporting, and accuracy in hospitals in California and comparison states. 2. Directly improve the accuracy and reliability of race, ethnicity, and language information collected by hospitals (direct improvement to self-reported data). 3. Use supplemental data and statistical approaches to improve race and ethnicity measures reported by hospitals (indirect improvement to self-reported data). Through this AHRQ-funded project, we expect to make substantial and sustainable improvements to the reporting of race, ethnicity, and primary language among patients receiving care in California's hospitals. PUBLIC HEALTH RELEVANCE: The aim of the proposed research is to incrementally improve the completeness and accuracy of self-report race, ethnicity, and language collected from all patients treated as inpatients, emergency department patients, or receiving ambulatory surgery in California hospitals. Results can be used to more accurately identify and address potential health and healthcare disparities arising through issues related to race, ethnicity, and language.