Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Aug;50 Suppl 1(Suppl 1):1372-89.
doi: 10.1111/1475-6773.12324. Epub 2015 Jun 15.

Improving Hospital Reporting of Patient Race and Ethnicity--Approaches to Data Auditing

Free PMC article

Improving Hospital Reporting of Patient Race and Ethnicity--Approaches to Data Auditing

David S Zingmond et al. Health Serv Res. .
Free PMC article


Objective: To investigate new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals.

Data sources: California Patient Discharge Database (PDD) and birth registry, 2008-2009, Healthcare and Cost Utilization Project's State Inpatient Database, 2008-2011, cancer registry 2000-2008, and 2010 US Census Summary File 2.

Study design: We examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort in California. Metrics were created to measure root mean squared differences (RMSD) by hospital between reported R/E distribution and R/E estimates using R/E distribution within each patient's zip code of residence. RMSD comparisons were made to corresponding "gold standard" facility-level measures within the maternal cohort for California and six comparison states.

Data collection: Maternal birth hospitalization (linked to the state birth registry) and cancer cohort records linked to preceding and subsequent hospitalizations. Hospital discharges were linked to the corresponding Census zip code tabulation area using patient zip code.

Principal findings: Overall agreement between the PDD and the gold standard for the maternal cohort was 86 percent for the combined R/E measure and 71 percent for race alone. The RMSD measure is modestly correlated with the summary level gold standard measure for R/E (r = 0.44). The RMSD metric revealed general improvement in data agreement and completeness across states. "Other" and "unknown" categories were inconsistently applied within inpatient databases.

Conclusions: Comparison between reported R/E and R/E estimates using zip code level data may be a reasonable first approach to evaluate and track hospital R/E reporting. Further work should focus on using more granular geocoded data for estimates and tracking data to improve hospital collection of R/E data.

Keywords: Data auditing; gold standard comparisons; race/ethnicity.


Figure 1
Figure 1
Rates of High (>20 percent) Disagreement and High Combined Other and Unknown Race/Ethnicity by State. (a) Rates of High (>20 percent) Disagreement of Race/Ethnicity Reporting RMSD between Hospital and US Census. (b) Rates of High Combined Other and Unknown Race/Ethnicity Reported by HospitalNotes. (a) Root mean square difference between average hospital reported race/ethnicity and that reported by the US Census.(b) Rates >10 percent by hospital.

Similar articles

See all similar articles

Cited by 6 articles

See all "Cited by" articles

Publication types

MeSH terms

LinkOut - more resources