Research shows variation in data used to address health disparities

For decades, national efforts to identify and combat inequities in American health care have relied on vast amounts of anonymous medical record data from tens of millions of people.

And because many of these inequalities are between groups of people from different racial and ethnic backgrounds, it is important to accurately and consistently collect data on these characteristics when patients receive treatment. Especially important.

But new research shows this doesn’t always happen.

1.7% of adults and 7% of children who sought emergency care at least twice at the same hospital or health system in Michigan had different races or ethnicities recorded on the patient records at different visits.

Almost 26% of adult patients were registered as Black and non-Hispanic at the time of their initial visit, and 39% of adult patients were registered as part of the other race and ethnicity umbrella category at their first visit. A different race or ethnicity was recorded during her second emergency visit to the same hospital or health system.

Among children who were recorded as White, multiracial, or other at their first visit, they were recorded as being of another race or ethnicity at their second emergency visit, 32% and 18%, respectively. 23% experienced this difference.

The findings suggest that hospitals and health systems need to do more to standardize their practices for collecting racial and ethnic data in emergency departments. What is recorded in the patient’s record in the ED may not be reexamined during treatment during the hospitalization or post-acute visit. In some cases, the only care available to underprivileged populations is an emergency room visit.

The study looked at data from more than 500,000 people who had two or more emergency visits to 42 hospitals between the end of 2018 and the end of 2021. JAMA network open It was created by a team from Harvard University, the University of Michigan, and Northwestern University, and is based on data from a registry maintained by the Michigan Emergency Department Improvement Collaborative (MEDIC).

Keith Kocher, M.D., MPH, who leads MEDIC and is the senior author of the new study, said the study shows that “current racial and ethnic data in electronic medical record systems has a significant impact on administrative decisions, clinical processes, research, and or for countless other purposes.”

Kocher, an emergency medicine physician and researcher at Michigan Medicine and the University of Michigan Institute for Health Policy Innovation, trained in IHPI’s National Clinician Scholars Program before moving to IHPI, and was co-authored with first author Rama Sarhi, MD; Collaborated with MHS, M.S. Harvard University and Massachusetts General Hospital.

In an accompanying editorial, a team of health disparities research experts wrote, “To adequately measure and address pervasive racial and ethnic health disparities through data-driven policies that promote health equity, “We need high-quality data.”