Responses of Massachusetts hospitals to a state mandate to collect race, ethnicity and language data from patients: a qualitative study

Abstract

BackgroundA Massachusetts regulation implemented in 2007 has required all acute care hospitals to report patients' race, ethnicity and preferred language using standardized methodology based on self-reported information from patients. This study assessed implementation of the regulation and its impact on the use of race and ethnicity data in performance monitoring and quality improvement within hospitals.MethodsThematic analysis of semi-structured interviews with executives from a representative sample of 28 Massachusetts hospitals in 2009.ResultsThe number of hospitals using race, ethnicity and language data internally beyond refining interpreter services increased substantially from 11 to 21 after the regulation. Thirteen of these hospitals were utilizing patient race and ethnicity data to identify disparities in quality performance measures for a variety of clinical processes and outcomes, while 16 had developed patient services and community outreach programs based on findings from these data. Commonly reported barriers to data utilization include small numbers within categories, insufficient resources, information system requirements, and lack of direction from the state.ConclusionsThe responses of Massachusetts hospitals to this new state regulation indicate that requiring the collection of race, ethnicity and language data can be an effective method to promote performance monitoring and quality improvement, thereby setting the stage for federal standards and incentive programs to eliminate racial and ethnic disparities in the quality of health care.

Long-term retention in Office Based Opioid Treatment with buprenorphine

“…Murphy, 2009) Race/ethnicity was categorized as white, black, Hispanic or other, during patient registration based on patient self-report in pre-specified categories as required by state law. (Jorgensen, Thorlby, Weinick, & Ayanian, 2010) When data were incomplete or lacked sufficient detail, two trained reviewers (D.H. and H.K.) and a physician (Z.W.)…”

Potential harms associated with routine collection of patient sociodemographic information: A rapid review

“…Four (22.2%) studies exclusively assessed providers’ perceptions of the potential harms for patients from the routine collection of sociodemographic data . The remaining three (16.7%) studies assessed both patients’ perceptions or experiences of harms and providers’ perceptions of harms …”

“…The included studies were conducted in the USA (66.7%), Canada (27.8%) and the UK (11.1%) . Three studies employed a mixed‐methods design, eight studies used a quantitative design, and the remaining seven used a qualitative design . Three studies included a large variety of racial/ethnic groups including white, black/African American, Latino/Hispanic, Asian and multiracial participants .…”

“…One study (reported in two papers) included a range of participants including community leaders, health‐care workers, health‐care service users and health policy decision makers . Health‐care representatives (eg hospital executives and physicians) were participants in the remaining studies . The characteristics of the included studies are described in Table , and a map of the potential harms reported in each study is provided in Table .…”

“…All 13 studies reporting patients’ perceptions or experiences assessed the harms associated with the collection of race/ethnicity/culture/language data . Three studies assessed the harms associated with the collection of income data, and two studies assessed the harms associated with the collection of religion data .…”