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Measuring Health Disparities: Effects of Underlying Quality of Ethnicity Data Jay S Buechner, Ph.D. Rhode Island Department of Health 2007 Annual Conference on Assessment Initiative August 22-24, 2007 Assessment Initiative 2007 Eliminate Health Disparities Healthy People 2010 Goal:

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Measuring Health Disparities:Effects of Underlying Quality of Ethnicity Data

Jay S Buechner, Ph.D.

Rhode Island Department of Health

2007 Annual Conference on Assessment Initiative August 22-24, 2007


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Assessment Initiative 2007

Eliminate Health Disparities

Healthy People 2010

Goal:

How do we measure progress?


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Assessment Initiative 2007

Priorities for RI’s Web Query System


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Assessment Initiative 2007

Operational Barriers

  • Small Numbers

  • Comparability

  • Data Quality


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Assessment Initiative 2007

Operational Barriers

  • Small Numbers

  • Comparability

  • Data Quality


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Assessment Initiative 2007

Operational Barriers

  • Small Numbers

  • Comparability

  • Data Quality


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Assessment Initiative 2007

Operational Barriers

  • Small Numbers

  • Comparability

  • Data Quality


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Assessment Initiative 2007

Data Quality Issues

  • Sample Surveys

    • Self-reported

    • Non-standard responses

    • Refusals

    • Bias

  • “Registries”

    • Self-reported?

    • Missing data

    • Under-reporting


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Assessment Initiative 2007

Ad Hoc Data Quality Study Through

Data Linkage

  • Hospital Discharge Data

    • “Administrative Data”

    • Collected/reported by hospital staff

  • Traumatic Brain Injury Data

    • Abstracted from medical record

    • Collected by project staff


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Assessment Initiative 2007

HDD Record

TBI Record

Race/Ethnicity

80.8%

75.0%

White

5.1%

5.2%

Black

1.2%

1.4%

Asian

<0.05%

0.8%

Native American

6.7%

8.0%

Hispanic

5.1%

3.6%

Other

1.1%

6.0%

Unknown

Comparative Race/Ethnicity Distributions HDD Record vs TBI RecordRhode Island, 1996-1999


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Assessment Initiative 2007

Correspondence of HDD Record with TBI Record, Rhode Island, 1996-1999

98.5

100

90.4

89.8

88.4

77.3

80

64.7

60

Percent "Correct" on HDD Record

40

15.2

20

5.3

0

White

Black

Asian

Native

Hispanic

Other

Unknown

All

American

Cases

Race


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Assessment Initiative 2007

Hispanic Surname Study,

RI Cancer Rates

  • From Bureau of Census:

    • List of 639 “heavily Hispanic” surnames

  • Apply to:

    • RI Cancer Incidence (Males)

    • RI Cancer Deaths (Males, Females)


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Assessment Initiative 2007

Hispanic Male Cancer Cases, Rhode Island, 1989-1998

80

Method

70

Combined

Surname

60

Reported

50

Number of Cases

40

30

20

10

0

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

Year of Diagnosis


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Assessment Initiative 2007

Recommendations/Suggestions

  • Establish a data collection policy

  • Evaluate reported data on race and ethnicity regularly

  • Establish and support improved data collection


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Jay Buechner

Chief, Center for Health Data & Analysis

401.222.5115

jay.buechner@health.ri.gov

www.health.ri.gov


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