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Collecting, Using, and Disseminating Health Data on Minority Populations
Existing Data Sources
Carla Zema, Ph.D., Service Fellow, Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality (AHRQ).
Roxanne Andrews, Ph.D., Senior Service Fellow, Center for Organization and Delivery Studies, Agency for Healthcare Research and Quality (AHRQ).
Patricia M. Golden, M.P.H., former Special Assistant for Minority Health Data, Division of Analysis, Epidemiology and Health Promotion, National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC).
This session provided more in-depth information about using AHRQ's Consumer Assessment of Health Plans (CAHPS®) and Healthcare Cost and Utilization Project (HCUP) data sources in assessing minority population health. This session also addressed methodological issues affecting use and interpretation of data.
Carla Zema described AHRQ's CAHPS®, which is a standardized instrument used to assess:
- Consumer/patient choice.
- Quality improvement.
- Health plan/provider reimbursement/incentives.
Zema explained that CAHPS® builds on patient satisfaction research by asking patients questions about what took place during their care interaction. CAHPS® can detect racial/ethnic differences in consumer assessment of patient care in health plans. CAHPS® has been translated into several languages, including Spanish, Russian, Vietnamese, Mandarin, Korean, and Cambodian.
Roxanne Andrews described AHRQ's HCUP databases. HCUP includes the largest collection of longitudinal hospital care data in the U.S. The data was developed through a partnership among states, the health care industry, and AHRQ. The data, compiled in a uniform format, includes clinical, demographic, and resource utilization information, including all inpatient discharge data from participating States.
Currently, 22 states collect race and ethnicity data as part of their HCUP State Inpatient Database (SID). Minority health issues that can be examined with SID files include:
- Use and cost of services.
- Medical treatment variations.
- Quality assessment.
- Access to care.
- Diffusion of medical technology.
- Care of special populations.
HCUPnet is an interactive on-line access to HCUP data that allows cross-classifying by patient and hospital characteristics such as race. Minority health issues that can be examined using HCUPnet state statistic measures include:
- Number of discharges.
- Length of stay.
- Discharge status.
Examples of questions that can be answered using HCUPnet, include:
- What percentage of children's hospitalizations are uninsured, by race/ethnicity?
- What is the percentage of HIV/AIDS patients who are discharged to home health care, by race/ethnicity?
- What is the average length of stay for stroke patients, by race/ethnicity?
- What percent of patients admitted to rural hospitals are transferred to another hospital, by race/ethnicity?
Patricia Golden explained that there are variations in populations and methodologies across and within data systems. These variations may effect data availability and comparability such as with the new age-adjustment methodology, and 1990 and 2000 Census data.
Despite these variations, Golden discussed some of the improvements in the availability of data on racial and ethnic populations, such as:
- Collection of data on race and ethnicity in an increasing number of data systems.
- Expanded race and ethnicity categories.
- Oversampled populations.
Improvements in the access to health data on racial and ethnic populations include:
- Expanded publication of data.
- Greater availability of public use files.
- Access via the Internet.
Agency for Healthcare Research and Quality. From the Pipeline of Health Services Research—CAHPS®: The Story of the Consumer Assessment of Health Plans. AHRQ Pub. No.
00-P014, January 2000.
Agency for Healthcare Research and Quality. CAHPS® (Consumer Assessment of Health Plans). AHRQ Pub. No. 00-P047, May 2000.
Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project (HCUP) Web site: http://www.ahrq.gov/data/hcup/
Agency for Healthcare Research and Quality. HCUPnet Web site: http://hcupnet.ahrq.gov/
Agency for Healthcare Research and Quality. Quality Indicators Web site: http://www.qualityindicators.ahrq.gov
Anderson RN, Rosenberg HM. Age Standardization of Death Rates: Implementation of the Year 2000 Standard. National Vital Statistics
Reports. National Center for Health Statistics. Centers for Disease Control and Prevention (CDC). U.S. Department of Health and Human
Services (DHHS). October 1998.
U.S. Department of Health and Human Services. Directory of Health and Human Services Data Resources. http://aspe.hhs.gov/datacncl/datadir/index.shtml
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Healthy People 2010: Part C. U.S. Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health, 2nd ed.
Washington, DC: U.S. Government Printing Office, November 2000. http://www.healthypeople.gov/
Planned Approach to Community Health (PATCH): A Guide for the Local Coordinator. National Center for Chronic Disease and Health
Promotion. CDC. DHHS. http://www.cdc.gov/nccdphp/patch/
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