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Posted by / 11-Jul-2014 17:11

With the passage of the Civil Rights Act of 1964 there was a legislative mandate for equal access to and desegregation of hospitals (Reynolds, 1997).Therefore it is not surprising that more than 89 percent of hospitals report collecting race and ethnicity data, and 79 percent report collecting data on primary language (AHA, 2008).This culture of data collection has limitations, however.Historically, the data were never intended for quality improvement purposes, but to allow analysis to ensure compliance with civil rights provisions.Indirect estimation techniques, when used with an understanding of the probabilistic nature of the data, can supplement direct data collection efforts Addressing health and health care disparities requires the full involvement of organizations that have an existing infrastructure for quality measurement and improvement.Although hospitals, community health centers (CHCs), physician practices, health plans, and local, state, and federal agencies can all play key roles by incorporating race, ethnicity, and language data into existing data collection and quality reporting efforts, each faces opportunities and challenges in attempting to achieve this objective.

Thus, the consideration of other avenues of data collection and exchange is essential to the subcommittee's task.Until data are better integrated across entities, some redundancy will remain in the collection of race, ethnicity, and language data from patients and enrollees, and equivalently stratified data will remain unavailable for comparison purposes unless entities adopt a nationally standardized approach.Methods should be considered for incorporating these data into currently operational data flows, with careful attention to concerns regarding efficiency and patient privacy.Next is a discussion of steps that can be taken to address these issues and improve data collection processes.This is followed by a review of methods that can be used to derive race and ethnicity data through indirect estimation when obtaining data directly from many patients or enrollees is not possible.

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Explicitly expressing the rationale for the data collection and training staff, organizational leadership, and the public to appreciate the need to use valid collection mechanisms may improve the situation.

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