Objective: Cancer incidence, treatment, and prognosis show important disparities by race, Hispanic ethnicity, and birthplace, but hospital policies and procedures in obtaining this information are poorly documented. This study documented policies and procedures in a state (Connecticut) with a high-quality population-based cancer registry.
Methods: Directors of medical records and/or admissions at all 30 hospitals were surveyed, and hospital records were abstracted for a sample of 220 minority (African-American/Black, Asian, and Hispanic) cancer patients diagnosed in 2000-2001 at three hospitals of various sizes.
Results: At least one staff member at 86% of the 28 responding hospitals reported a hospital policy to ask patients about their race, vs 25% for ethnicity and 57% for birthplace, and patient self-reports were reportedly used to obtain race in 100% of hospitals vs 54% for ethnicity. Race was regarded as "very important" or "important" by staff at 89% of hospitals, vs only 46% for ethnicity and 61% for birthplace, and 68% of hospitals reported using a single item for both race and ethnicity. Results of record abstraction for the 220 minority patients at the three selected hospitals were generally consistent with data from surveys of hospital staff. Ethnicity was rarely recorded on any specific type of document, although preferred language was usually recorded. Disagreement in recorded race or ethnicity on different documents was rare (2%-3%).
Conclusions: Efforts are needed to educate hospital staff on the importance of collecting information on Hispanic ethnicity and birthplace. Similar studies are needed in other states.