Data on Race and Ethnicity in the National Health Care Survey

1. Data on Race and Ethnicity in the National Health Care Survey Irma E. Arispe, Ph.D. Associate Director for Science Division of Health Care Statistics National Center for Health Statistics Data Users Conference, 2002 National Center for Health Statistics

2. The National Health Care Survey • Family of establishment-based surveys • Data from health care providers and their medical/administrative records • Information on characteristics of providers, patients and visits • Purpose is to describe what is happening in the health care system, utilization of services, the content of encounters • Very useful for profiling trends over time

3. NHCS: Selected Components

4. Data from providers and medical recordsare very useful for... • Understanding how conditions present to and across the health care system • Understanding the content of the encounter, including disposition of care • Examining diffusion of innovations • Profiling practice, looking at quality of health care • Enhancing data from population-based surveys ...but they aren’t the best data source for understanding access the patient’s sociodemographic characteristics or perspective on the health encounter

5. Hospital Care: the National Hospital Discharge Survey (NHDS) • Collecting • Manual abstraction (Majority of hospitals) • Always permitted collection of multiple race • Since 2000, data from hospital records used the following categories: White, Black or AA, AI/AN, Asian, NH/OPI, other, not stated • Automated data (Majority of records) • Data obtained from states, abstracting services, hospitals • Data follow the UB 92 format which does not collect race or ethnicity • Reporting • Race generally not reported in publications, but data are included in the public use file • There were about 54 multiple race cases in 2000, grouped into other category. • Single race denominators used in 2000 for US civilian population (multiple race denominators from 2000 Census not available at time of publication)

6. Ambulatory Care: NAMCS & NHAMCS • Collecting • Beginning in 1999: White, Black/AA, Asian, NH & OPI, AI/AN • Reporting • Multiple race cases reported as “multiple race” if there are 30 or more such cases (NAMCS & OPD in 2000) • Multiple race cases coded as a separate category, included in public use file • Single race denominators used for rate calculation in 2000 for US civilian noninstitutionalized population (Year 2000 multiple race data not available at time of publication)

7. Long term care: NNHS and NHHCS • Collecting • Use minimum set for data on race for federal statistics … • in NNHS since 1999 • in NHHCS since 1998 • Data elements concordant with the MDS/OASIS • Reporting • About 10 multiple race cases in 1999; coded as other • Denominators currently are for single race, US civilian population, Year 2000 data not available • Data are missing more frequently for discharges than for current patients

8. Hispanic/Latino EthnicityMissing/Unknown in 2000

9. Issues in collecting race/ethnicity data in establishment based surveys • Survey participation is voluntary; Providers are not mandated to collect or report data • Confidentiality concerns discourage reporting of race and ethnicity • State laws do not mandate collection of race/ethnicity data • Data not included in some administrative data sources such as the UB 92, MDS or OASIS • Concerns exist about the quality of reported data • Small sample size precludes reporting • Increasing precision of categories decreases reporting capability